Necrotizing pancreatitis. This patient with alcohol-induced pancreatitis has much more extensive pancreatic necrosis. The pancreatic head (P) enhances normally but the body and tail are of much lower attenuation (yellow arrows) because of necrosis. This patient also has a small pseudocyst adjacent to his stomach (arrowhead). Thrombosis of the splenic and/or portal vein is another potential complication of acute pancreatitis which we have to look out for on CT – note the low attenuation filling defect in the portal vein (red arrow), representing thrombus. Alcohol abuse is one of several causes of a fatty liver (hepatic steatosis), which can be readily diagnosed on CT – the liver and spleen should be of very similar attenuation on CT however in this example you can see that the liver is of much lower density than the spleen (S), because of the increased fat content.