Figure 9b. Acute pancreatitis in an 18-year-old woman with three Ranson grave signs. (a) Initial early transverse CT scan obtained with intravenous and oral contrast material reveals an enlarged low-attenuating (50-70-HU) pancreas (P), consistent with pancreatic ischemia and necrosis. Degree of necrosis is difficult to ascertain. A large fluid collection (arrow) is seen around the pancreatic body and tail (t). (b) Follow-up transverse CT scan obtained 14 days later reveals a fluid collection associated with liquified necrosis of most of the body of the pancreas, with the development of a pseudocyst (c). Note that the tail of the pancreas (arrow) is enhancing normally at this time.