Figure 9a. Pancreatic necrosis in a patient who recently underwent pancreatic transplantation and who presented with fever, leukocytosis, and severe right lower quadrant tenderness. (a) Gray-scale sonogram shows multiple echogenic foci (arrow) within the substance of the pancreatic transplant, findings compatible with foci of intraparenchymal air. (b) Subsequent CT scan obtained later that day helps confirm the presence of intrapancreatic air (arrow). At surgery, the necrotic transplant was draped with purulent material.