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Walled‐off necrosis, similar to pseudocyst formation, develops after four weeks, but from an ANC as opposed to an APFC. It has a thick mature wall and contains necrotic fat and/or pancreatic tissues and fluid. On T2‐weighted images, different than pseudocyst, nonliquefied debris is present in the collection (Figure 6.2a). Post‐contrast T1‐weighted images will show an enhancing wall (Figure 6.2c).

MRI is highly accurate and reliable in making the diagnosis of any of these fluid collections, and in evaluating for possible connections with the pancreatic ductal system (Figure 6.2b) [14].

Disconnected or disrupted pancreatic duct is commonly associated with glandular necrosis. While ERCP is the best available diagnostic tool, it remains an invasive technique. MRI and MRCP are noninvasive and in some cases, such as upstream pancreatic duct disruptions, outperform ERCP, with studies demonstrating that MRI/MRCP has 95% accuracy in detecting pancreatic duct disruption [12,15].