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Question: A 55-year-old man with a history of chronic alcoholic pancreatitis presented with a 4-day history of progressively worsening abdominal pain, nausea, and vomiting. Physical examination revealed tenderness in the epigastrium, without guarding or rebound. Laboratory tests were significant for the following: white blood cell count, 16,600/mL; amylase level, 452 U/L; lipase level, 437 U/L; and C-reactive protein level, 32.5 mg/dL. Contrast-enhanced computed tomography (CT) of the abdomen showed a dilated main pancreatic duct, peripancreatic fluid collections, and fluid collection at the tail of the pancreas adjacent to the splenic hilum (Figure A). Because the patient was hemodynamically stable, he was initially managed conservatively, but the cystic lesion at the tail of the pancreas enlarged, and a follow-up CT performed 1 week later showed the cystic lesion extending into the splenic parenchyma (Figure …