Answer of March 2001

Clinical History:

middle-aged female admitted for vomiting and abdominal pain.

Figure 1 (AXR)
Figure 2 (CECT)
Figure 3 (CECT)

What is your diagnosis?

                           Figure 1

                           Figure 2

                           Figure 3

Diagnosis:

Pancreatic necrosis with portal vein gas.

Discussion:

Figure 1 AXR shows abnormal gas collection in the central abdomen above the transverse colon.

Figure 2 CT shows the whole of the pancreas is non-enhancing and replaced by gas. There is free fluid in the abdomen.

Figure 3 Gas is seen in the portal veins branches.

She was opened up.