A 40-year-old man with acute pancreatitis undergoes contrast-enhanced CT on day 4. The body of the pancreas fails to enhance with contrast while the head enhances normally. There is peripancreatic fat stranding. What does the non-enhancing area represent?

• A Pancreatic necrosis ✓
• B Pancreatic pseudocyst
• C Pancreatic divisum
• D Autoimmune pancreatitis

Explanation

Pancreatic necrosis is defined on contrast-enhanced CT as areas of the pancreatic parenchyma that fail to enhance after intravenous contrast administration, indicating ischemic cell death. This is the most important CT finding in severe acute pancreatitis and correlates with the modified CT severity index (MCTSI), which guides prognosis and management. Greater than 30% necrosis carries significantly increased morbidity and mortality. A pseudocyst is a fluid collection with a defined wall developing after 4 weeks. Pancreas divisum is a congenital ductal anomaly without parenchymal loss.

Reference: Grainger & Allison's Diagnostic Radiology, 7th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

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