50 year-old female with chronic pancreatitis and pancreatic exocrine insufficiency. Status post ERCP on 1/29, which showed pancreatic duct obstruction, unable to be passed endoscopically, assess stricture. ABDOMEN:LIVER, BILIARY TRACT: No intra- or extra-hepatic biliary ductal dilation. No focal mass lesion identified.SPLEEN: No evidence of splenomegaly.PANCREAS: There is atrophy of the pancreas as well as loss of the expected intrinsic T1 signal intensity, consistent with the stated history of chronic pancreatitis. Note is made of irregular contour and non-distensibility of the main pancreatic duct. There is a focal area of narrowing of the main pancreatic duct, approximately 1.7 cm proximal to the level of the ampulla, consistent with the stated history of main pancreatic duct stricture. Additionally, proximal to this area of focal narrowing, is a long segment of relative narrowing of the main pancreatic duct, at the level of the pancreatic body, measuring approximately 2.3 cm in length (as seen on series 1401). There is slight distention of the main pancreatic duct proximal to this region. There is a blunted response to secretin augmentation consistent with the stated history of pancreatic exocrine insufficiency.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: Simple cysts are identified within the kidneys bilaterally.RETROPERITONEUM, LYMPH NODES: No evidence of lymphadenopathy.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality noted.
1.Findings consistent with the stated history of chronic pancreatitis. There are multiple foci of narrowing affecting the main pancreatic duct, consistent with the stated history of main pancreatic duct stricture, likely related to sequelae of chronic pancreatitis. No obstructing focal mass lesion identified. 2.Blunted response to secretin augmentation, consistent with the stated history of pancreatic exocrine insufficiency which may also be related to the patient's history of chronic pancreatitis. 