Case of the Week: Necrotizing Pancreatitis (CT & MRI)

In this radiology lecture, we discuss the imaging appearance of necrotizing pancreatitis on both CT and MRI.

Key points include:

  • According to the revised Atlanta classification, there are two types of acute pancreatitis: Interstitial edematous pancreatitis (IEP) and necrotizing pancreatitis (NP).
  • For IEP, fluid collection in first 4 weeks = acute peripancreatic fluid collection, after 4 weeks = pseudocyst.
  • For NP, fluid collection in first 4 weeks = acute necrotic collection, after 4 weeks = walled-off necrosis.
  • Non-enhancing hypoattenuating areas = necrotizing pancreatitis.
  • Gas suspicious for infection/emphysematous pancreatitis.
  • Vascular complications are important to identify.
  • Venous thrombosis: splenic, portal, and mesenteric veins.
  • Pseudoaneurysms: Splenic and gastroduodenal artery.

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