CT of mediastinal pancreatic fluid collections

Mediastinal extension of an extrapancreatic fluid collection is a rare event. Only 30 cases have been previously reported in the literature. An additional case is presented. In the appropriate clinical setting, plain film and contrast examination of the esophagus and stomach may suggest the diagnosis. While ultrasound may identify supradiaphragmatic extension of fluid, computed tomography is better able to demonstrate the nature and extent of a mediastinal extrapancreatic fluid collection. Preoperatively it is important to recognize that a mediastinal mass represents an extrapancreatic fluid collection because the preferred surgical approach is abdominal.