Male 65 years old Reason: 64 yo male s/p whipple for IPMN in 4/14; please evaluate for abnormalities History: pancreas mass LUNG BASES: Right basal scarring/atelectasis.ABDOMEN:LIVER, BILIARY TRACT: Hepatic steatosis. Subcentimeter T2 hyperintensity within the posterior right hepatic lobe is consistent with a hepatic cyst. SPLEEN: No significant abnormality noted.PANCREAS: Status post Whipple. There is marked dilatation of the pancreatic duct throughout its course, measuring up to 8 mm and increased compared to most recent CT abdomen 26/04/14. No definite enhancing mass is identified within the pancreas. Given the time interval, stricture is the most likely etiology.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: Bilateral renal cysts.RETROPERITONEUM, LYMPH NODES: Nonspecific mildly prominent portacaval lymph node.BOWEL, MESENTERY: Changes related to prior Roux-en-Y.BONES, SOFT TISSUES: T2 hyperintensities within the lower thoracic vertebral bodies are suggestive of hemangiomas.
1.Increased dilatation of the pancreatic duct in this patient who is status post Whipple. Given the time interval favor stricture as most likely etiology of the dilatation. While pancreatic mass or a main branch IPMN are differential considerations, there are no specific imaging findings to suggest these diagnoses which are therefore felt much less likely. 2.Hepatic steatosis. 