File:Necrotic pancreatitis - perforated cholecystitis (Radiopaedia 82321-96403 A 9).jpg

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Necrotic_pancreatitis_-_perforated_cholecystitis_(Radiopaedia_82321-96403_A_9).jpg ‎(512 × 512 pixels, file size: 113 KB, MIME type: image/jpeg)

Summary:

Description
  • Radiopaedia case ID: 82321
  • Image ID: 53919532
  • Image stack position: 9/84
  • Plane projection: Axial
  • Aux modality: C+ portal venous phase
  • Study findings: The walled-off necrosis fully developed with a complete enhancing wall and internal foci with the fat density. The air bubbles within the walled-off necrosis in the first series could be due to recent ERCP, but infected necrosis should be excluded. The gallstones visible on previous CT scans are no longer visible. The gallbladder contains air, and a fistulous tract from the gallbladder fundus to the hepatic flexure of the colon is visible, suggestive of fistulization. The stones are now visible within the lumen of the colonic hepatic flexure(first series).
  • Modality: CT
  • System: Gastrointestinal
  • Findings: Evidence of pancreatitis is seen as pancreatic edema, peripancreatic fatty haziness, and retroperitoneal fascial thickening on the left side. The pancreatic body does not show normal enhancement despite enhancing pancreatic head or distal tail, suggestive of pancreatic necrosis (more than 50%, score 6). At least one acute fluid collection (likely acute necrotic collection) is visible in the lesser sac (Balthazar score 3, CT severity index 9). At least one stone at the pancreatic portion of the CBD and another one at the distal cystic duct just before insertion to the CBD, and several gallstones are visible, in favor of biliary pancreatitis.
Date Published: 22nd Nov 2020
Source https://radiopaedia.org/cases/necrotic-pancreatitis-perforated-cholecystitis-1
Author Faeze Salahshour
Permission
(Permission-reusing-text)		 http://creativecommons.org/licenses/by-nc-sa/3.0/

Licensing:

Attribution-NonCommercial-ShareAlike 3.0 Unported (CC BY-NC-SA 3.0)

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