History of pancreatitis and annular pancreas, please evaluate for abnormalities or obstruction. ABDOMEN:LIVER, BILIARY TRACT: The liver demonstrates normal parenchymal signal intensity without focal lesions. The gallbladder is mildly prominent in size without cholelithiasis or evidence of cholecystitis.There is mild intrahepatic biliary ductal dilatation within the central intrahepatic bile ducts measuring up to 5 mm. The common hepatic and proximal common bile duct are mildly dilated measuring up to 6 mm up until the pancreatic head where the common bile duct smoothly narrows to diameter of approximately 2 mm for length of approximately 2.7 cm until the ampulla. There is mild circumferential enhancement surrounding the narrowed portion of common bile duct on delayed images which may be related to chronic inflammatory change.SPLEEN: No significant abnormality noted.PANCREAS: Pancreatic parenchyma appears to partially encase the second portion of the duodenum suggestive of at least partial annular pancreas. The pancreatic parenchyma demonstrates normal signal intensity. The pancreatic duct measures up to 3 mm in diameter. The pancreatic duct is not well-visualized in the pancreatic head but appears to join the common bile duct approximately 3 cm from the ampulla. There is mild circumferential enhancement surrounding the visualized portions of the proximal pancreatic duct on delayed images which may be related to chronic inflammatory change from repeated bouts of pancreatitis. 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.
1.Findings suggestive of at least partial annular pancreas.2.Suspected approximately 3 cm common channel of pancreatic duct and common bile duct which may be partially related to the annular pancreas morphology.3.Approximately 2.7 cm segment narrowing of the distal common bile duct with upstream mild biliary ductal dilatation which may also be related to annular pancreas. 4.Mild circumferential delayed enhancement surrounding the narrowed distal common bile duct as well as pancreatic duct in the pancreatic head and proximal body suggestive of chronic inflammatory change, likely from known bouts of pancreatitis.5.Pancreatic duct is compliant following administration of secretin.