History of RCC and duodenal carcinoid tumor status post Bilroth II on September 10, 2015, now with GJ tube secondary to delayed gastric emptying with high gastric residuals ABDOMEN:LIVER, BILIARY TRACT: Small layering sludge in gallbladder. No secondary signs of acute cholecystitis.SPLEEN: No significant abnormality noted.PANCREAS: 1.6 cm pancreatic body cystic focus (punctate wall calcification better seen on earlier CT imaging), most likely a sidebranch intraductal papillary mucinous neoplasm. Pancreatic duct normal in size. No pancreas divisum.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: Dominant left simple renal cyst measuring up to 13 cm in longitudinal dimension, additional smaller renal cysts also seen. Mild fullness of left mid to lower renal collecting system without significant change from prior CT imaging. Absent right kidney.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Percutaneous gastrojejunal tube seen entering gastric body with tip located beyond ligament of Treitz in left upper quadrant jejunum. Collapsed stomach. Gastroenteric anastomosis unremarkable.BONES, SOFT TISSUES: Ventral abdominal postsurgical sequela including adjacent scarring. Deep to this area is a 1.3 x 0.8 cm focus of enhancing nodularity, persistent to increased enhancement seen in delayed phase, may reflect postsurgical sequela such as scarring or fat necrosis but attention on follow-up recommended to exclude interval increasing size. T9 vertebral body T2 and T1 hyperintense focus most likely a vertebral body hemangioma. Partially imaged aneurysmal ascending thoracic aorta.
Gastroenteric anastomosis unremarkable, no evidence of bowel obstruction. Deep to region of ventral abdominal postsurgical changes is 1.3 cm focus of enhancing nodularity as above, likely reflecting postsurgical scarring or fat necrosis but attention on follow-up suggested.1.6 cm pancreatic body cystic lesion, most likely a sidebranch IPMN.Gallbladder sludge.