Case 1

This is a CT study of the abdomen and pelvis, which includes post contrast series; it shows a diffusely enlarged pancreas which is hypo-enhancing. There are retroperitoneal fluid collections surrounding the pancreas and extending to the anterior pararenal space, lesser sac, paracolic gutters and pelvis. There are no parts of the pancreas which do not enhance, which would suggest necrosis. I note the absence of any pseudo-aneurysms.  

These findings indicate acute interstitial oedematous pancreatitis with acute peri-pancreatic fluid collections.

This is complicated by intra and extrahepatic biliary dilatation, due to obstruction at the level of the pancreatic head portion of the CBD due to oedema and swelling of the surrounding pancreatic tissue.

There is an incidentally found lesion in the right adrenal gland, which shows avid peripheral enhancement and no central enhancement. This likely represents a phaeochromocytoma; however, an adreno-cortical carcinoma is also possible.

There are incidentally noted round masses in the subcutaneous fat of the gluteal regions, which likely represent injected filler material.

In the first instance, I would urgently contact the referring physician and inform of the findings as this constitutes an emergency. After the acute pancreatitis is managed and resolved, the adrenal lesion could be further investigated. Biochemical testing for catecholamines / metanephrines may be performed to diagnose a phaeochromocytoma, as well as I-123 MIBG scan.