Reason: 42 yo F with history of sphincter of Oddi dysfunction s/p biliary sphincterotomy in 2007, with persistent abdominal pain. MRI/MRCP with gadolinium and secretin to assess for biliary or pancreatic stricture as cause of pain, also pancreatic parenchyma History: abdominal pain in setting of history of sphincter of Oddi dysfunction ABDOMEN:LIVER, BILIARY TRACT: Punctate hepatic dome T2 hyperintensity, likely a cyst. No suspicious enhancing lesions. No intrahepatic or extrahepatic biliary ductal dilatation. Status post cholecystectomy.Common bile duct is normal in caliber measuring 4 mm. No intrahepatic biliary ductal dilatation. Mild narrowing at the distal right hepatic duct without proximal dilatation may be technical. Incidentally noted is a draining branch from the right liver into the left hepatic duct.SPLEEN: No significant abnormality noted.PANCREAS: Main pancreatic duct appears normal. Pancreatic parenchyma is normal appearing. No suspicious pancreatic lesions. Normal response to secretin administration.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: There are multiple dilated jejunal loops measuring up to 3.1 cm. There is apparent mass within the cecum at the level of the ileocecal valve which measures 3.8 x 2.6 cm which appears to enhance on postcontrast images (8/29).BONES, SOFT TISSUES: No significant abnormality noted.OTHER: Small amount of free fluid is present within the pelvis.
1. Multiple dilated jejunal loops. Small bowel obstruction may be considered although this is not well evaluated on this study. Recommend CT enterography for further evaluation.2.Suspected enhancing mass in the cecum can be further evaluated on subsequent CT.3.Apparent narrowing of the distal right hepatic duct is most likely technical, no upstream dilatation seen to suggest flow-limiting stricture. The biliary system and pancreas are otherwise unremarkable.