History of gallstone pancreatitis and pancreatic pseudocyst. ABDOMEN:LIVER, BILIARY TRACT: Status post cholecystectomy. Mild central intrahepatic and extrahepatic ductal dilatation. The duct tapers smoothly in the pancreatic head without a discrete mass lesion or filling defect suggesting a benign stricture.No suspicious hepatic lesion. The hepatic vasculature is patent.SPLEEN: The spleen is normal in size. Chronic thrombosis of the splenic vein with collateral vessel formation. There is a stable arterial enhancing lesion measuring 2.6 cm (series 16/52) and the anterior aspect of the spleen which demonstrates T1 weighted isointensity and T2 weighted hypointensity relative to the spleen. This is nonspecific but may represent a sclerosing angiomatoid nodular transformation of the spleen.PANCREAS: Findings suggesting pancreas divisum. Demonstrated again is marked atrophy, decreased intrinsic T1 weighted signal and postcontrast enhancement of the pancreatic neck, body and tail. The pancreatic head is relatively preserved.The pancreatic duct is mildly prominent tortuous and irregular in contour likely reflecting multifocal strictures of chronic pancreatitis. Smooth focal pancreatic ductal narrowing at the pancreatic neck/body. Numerous cystic foci throughout the pancreas likely represent dilated side branch ducts related to chronic pancreatitis and less likely IPMNs.The 1.5 cm simple cystic lesion in the pancreatic head may represent a dilated side branch and is unchanged.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.
Stable findings consistent with chronic pancreatitis with relative sparing of the pancreatic head. The multiple cystic foci likely represent dilated side branch ducts due to multifocal stricturing of the main pancreatic duct and are not significantly changed; small IPMNs without suspicious imaging features cannot be entirely excluded. No evidence of acute inflammation or significant drainable fluid collection. Findings suggesting pancreas divisum. No suspicious pancreatic lesion is evident. Stable additional findings as above.