Female 60 years old Reason: f/u abnl pancreas imaging on CT. On HD, Please use IV contrast, pt agrees to use and understands NSF risks. History: same ABDOMEN:LIVER, BILIARY TRACT: No focal hepatic lesion. No significant intrahepatic biliary ductal dilatation. Status post cholecystectomy. Common bile duct measures 9 mm.SPLEEN: No significant abnormality noted.PANCREAS: Pancreatic duct measures 4 mm. It is dilated in its entirety up to the level of the ampulla. No discrete mass lesion is identified although the study is limited due to the lack of intravenous contrast. The narrowing appears to be at the level of the ampulla.ADRENAL GLANDS: There is a right adrenal gland nodule which is not significantly changed since 2007 and is presumed benign.KIDNEYS, URETERS: Atrophic kidneys with bilateral renal cysts.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.
1.Mildly dilated pancreatic duct without definite mass lesion. The obstruction is at the level of the ampulla and may be due to ampullary stenosis. The abnormal finding can be followed up with a 3 to 6 month MRI/MRCP if EUS or ERCP is not performed.