A 65-year-old woman with a recent history of acute necrotizing pancreatitis presented with a 5-day history of abdominal pain and fevers. Physical examination was notable for tenderness in the upper abdomen. Computed tomography of the abdomen is shown. What is the diagnosis?
一位65岁女性,近期有急性坏死性胰腺炎病史,主诉腹痛伴发热5天。体格检查发现上腹部有压痛。腹部CT影像如图所示。请问诊断是什么?

A. Cystic pancreatic neoplasm囊性胰腺肿瘤
B. Intra-abdominal abscesses腹腔内脓肿
C. Pancreatic pseudocyst胰腺假性囊肿
D. Solid pancreatic tumor实性胰腺肿瘤
E. Walled-off pancreatic necrosis包裹性胰腺坏死
答案解析:
根据腹部CT显示,胰腺区域可见一个边界清楚的大型液性包块,内含气体及分隔,并延伸至双侧腹膜后间隙,因此诊断为包裹性胰腺坏死。这是急性坏死性胰腺炎的晚期并发症,其定义为由坏死组织和液体形成的被包裹的积液。处理策略需逐步升级,包括:使用抗菌药物、经皮引流和随后行内镜引流
正确答案:E
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