Demographics:
55 years old, Male
Indication:
Severe upper abdominal pain
Findings
Lower chest
- Small left greater than right pleural effusions
- Mild dependent bilateral lower lobe atelectasis
- Coronary artery calcification
Abdomen/Pelvis
- Hypoenhancement of the pancreatic body as well as of portions of the head and tail
- Peripancreatic collection in the lesser sac measuring 13 x 8 x 9 cm
- Fluid tracks along the left anterior pararenal space with adjacent parietal peritoneal thickening
- Adjacent mural thickening of the second and third portions of the duodenum
- Hepatomegaly with diffusely decreased attenuation of the hepatic parenchyma
- Mild gallbladder distension without radiopaque gallstones, gallbladder wall thickening, or biliary duct dilation
- Small volume fluid layering in the anatomic pelvis
- Atherosclerotic calcification of the abdominal aorta and branch vessels without aneurysm
MSK
- Mild body wall edema
- Skin thickening along the pannus
- Multilevel degenerative changes of the spine, with lumbar levocurvature centered at L2-L3 where there is right eccentric advanced degenerative disc disease
Diagnosis
Necrotizing pancreatitis
Sample Report
Acute necrotizing pancreatitis with an acute necrotic collection in the lesser sac, which should be more accessible to endoscopic rather than percutaneous drainage. No gas is identified within this collection. No evidence of associated vascular complication.
Secondary duodenitis without evidence of obstruction. There is also likely secondary peritonitis.
Hepatomegaly with hepatic steatosis.
Small pleural effusions.
Discussion