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CT Abd Pancreatitis, Pseudocyst

FINDINGS: Peripancreatic fat stranding and fluid are noted in the anterior pararenal space. There is no evidence of pancreatic necrosis or pseudocyst formation. Dilatation of the common bile duct, 10 mm in diameter, is a new finding. Surgical clips seen in the gallbladder fossa are compatible with prior cholecystectomy. A small amount of intraperitoneal fluid is noted. The liver, spleen, adrenals and kidneys are without focal lesions. Enteric contrast is seen within the colon. The hollow viscera are without evidence of wall thickening, mass or obstruction. There is no lymphadenopathy. Osseous structures are unremarkable. IMPRESSION: 1. Uncomplicated acute pancreatitis. 2. Status post cholecystectomy. -------------------------------- FINDINGS: There is interval development of new bilateral pleural effusions, worse on the left with associated left lower lobe collapse. Diffuse peripancreatic fat stranding persists but now with a developing fluid collection within the lesser sac which is now more defined. There is a central area of vague low density in the body of the pancreas which may represent developing necrosis. Fluid is noted within the bilateral paracolic gutters with extension into the pelvis. There is significantly larger accumulation of pelvic fluid when compared with prior, measuring 8.4 x 10.2 cm. This appears more loculated compared to prior but without evidence of enhancing margins. The liver is normal. Cholecystectomy clips are noted within the gallbladder fossa. Stent is noted within the common bile duct. The spleen, adrenals and kidneys are unremarkable. Enteric contrast is seen within the colon. The hollow viscera are without evidence of wall thickening, mass or obstruction. There is no lymphadenopathy. Osseous structures are unremarkable. IMPRESSION: 1. Acute pancreatitis as above. Findings above are suggestive of development of a pancreatic pseudocyst within the lesser sac. 2. Possible developing necrosis in the body of the pancreas. 3. Enlargement and loculation of pelvic fluid collection may represent early abscess. Recommend interval follow up imaging as clinically dictated.