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RADIOLOGY: PANCREAS: Case# 33682: MULTIPLE ENCAPSULATED FLUID COLLECTIONS SURROUNDING THE PANCREAS; NECROSIS OF THE PANCREATIC HEAD, NECK, AND DISTAL BODY. 59-year-old female with pancreatitis. S/P transgastric drainage of fluid collection. 1) Multiple encapsulated fluid collections surrounding the pancreas, the largest reduced in size with two pigtail drainage tubes extending through the duodenum to its center. Two other fluid collections anterior to the spleen relatively unchanged. The fourth fluid collection anterior to the body of the pancreas, behind the stomach, is increased in density consistent with blood, infection, or residual necrosis.2) Necrosis of the pancreatic head, neck, and distal body with replacement by the largest fluid collection. 3) Thrombus is again identified in the splenic vein, superior mesenteric vein, and portal vein with strandy soft tissue changes in the peripancreatic area consistent with varices. 4) Moderate to large amount of ascites unchanged. 5) Left pleural effusion with passive atelectasis of the left lung base, unchanged. 6) Multiple hepatic cysts less than 1 cm in size again identified.

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