Reason: h/o chronic pancreatitis with pseudocyst, new onset fever, tachycardia; eval for edema/infection/necrosis ABDOMEN:LUNG BASES: Moderate left pleural effusion, increased from prior with associated left basilar atelectasis/consolidation.LIVER, BILIARY TRACT: No focal hepatic lesions. The hepatic vasculature appears patent. No biliary ductal dilatation.SPLEEN: No significant abnormality noted.PANCREAS: The pancreas is somewhat enlarged and demonstrates decreased T1 signal with associated peripancreatic edema compatible with acute pancreatitis. There are several discrete fluid collections which were also present on the prior examination. These include a rounded collection with a well-defined wall within the pancreatic body measuring 6.2 x 6.9 cm, increased from approximately 4.3 x 4.5 cm previously. There are several smaller additional contiguous fluid collections extending superiorly along the greater curvature of the stomach the largest of which measures approximately 2.8 x 3.1 cm (401/38). Though these were poorly visualized on the 3/10/2016 noncontrast examination, there were present on the 2/12/2016 exam but appear to have increased in size. The collections along the greater curvature demonstrate peripheral enhancement and restricted diffusion raising the possibility of superinfection.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: Pancreatic and peripancreatic fluid collections as described above with left greater than right retroperitoneal fat stranding.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.
1.Acute pancreatitis with several pancreatic and peripancreatic fluid collections overall increased in size from prior. Collections along greater curvature of stomach demonstrate peripheral restricted diffusion and enhancement raising the possibility of superinfection.2.Increased left pleural effusion with basilar consolidation/atelectasis compatible with pneumonia.