77 year old male with history of biliary stricture and evidence of chronic pancreatitis on EUS. ABDOMEN:LIVER, BILIARY TRACT: The liver is normal in contour. There is mild extrahepatic biliary duct dilatation with the common bile duct measuring 12 mm in diameter, appearing similar to the prior study. There is associated narrowing at the level of the head of the pancreas. No significant intrahepatic biliary ductal dilatation. No focal parenchymal lesions. Status post cholecystectomy.SPLEEN: No significant abnormality noted.PANCREAS: There is marked atrophy of the pancreas. A small volume of residual tissue demonstrating signal characteristics of normal pancreas remains in the pancreatic head, unchanged. The main pancreatic duct is markedly dilated measuring 12 mm in diameter, previously 10 mm. The main pancreatic duct is again noted to smoothly taper just proximal to its junction with the common bile duct. No mass lesion is evident. In response to secretin administration, there is normal opacification of the entire duodenum up to the ligament of Treitz, however, there appears to an overall blunted response to secretin augmentation.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: Multiple bilateral simple renal cysts.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: Hemangioma in the L2 vertebral body.OTHER: No significant abnormality noted.
Persistent findings consistent with chronic pancreatitis. There is main pancreatic duct and common bile duct dilation with associated narrowing at the level of the pancreatic head, most consistent with benign stricturing which may be a sequela of chronic pancreatitis. There are no focal pancreatic mass lesions identified.