Figure 2. CT image showing walled-off necrosis (WON) causing pancreaticduct disruption (PDD). A young, otherwise healthy male with moderately severe acute alcoholic pancreatitis developed an acute necrotic collection (ANC) in the mid-body of the pancreas that matured into WON (asterisk) over the subsequent month. The patient had recurrent symptoms and failure to thrive due to failure of the secretions from the viable pancreatic tail (arrows) to traverse the area of pancreatic necrosis (asterisk) to reach the viable pancreatic head (solid arrowheads). Percutaneous and endoscopic efforts failed, and he underwent successful open debridement, with a Roux-en-Y cystojejunostomy. After an uncomplicated recovery, he is well nearly 2 years later.