Reason: 75F hx of chronic pancreatitis on prior EGD/EUS and family history of pancreatic cancer, evaluate pancreas for any changes. ABDOMEN:LIVER, BILIARY TRACT: There is normal signal intensity and homogeneous enhancement of the liver without focal lesion. No intra or extra hepatic biliary ductal dilatation is identified. There is a large stone in the gallbladder fundus. The hepatic and portal veins are patent.SPLEEN: No significant abnormality noted.PANCREAS: No discrete pancreatic lesion is identified. There is mild atrophy of the pancreatic tail. There is slight irregularity of the main pancreatic duct but no focal stricture is identified. There is a slightly blunted response to secretin.ADRENAL GLANDS: Enhancing right adrenal nodule is again seen, measuring 1.7 x 0.9 cm, unchanged.KIDNEYS, URETERS: Status post right nephrectomy. The left kidney appears normal.RETROPERITONEUM, LYMPH NODES: No significant retroperitoneal lymphadenopathy.BOWEL, MESENTERY: Normal bowel caliber without obstruction.BONES, SOFT TISSUES: No focal osseous lesion is identified.OTHER: No significant abnormality noted.
1.No focal pancreatic lesion is identified to suggest pancreatic malignancy.2.There is improved but mild residual peripancreatic inflammation with irregularity of the pancreatic duct and mild atrophy of the pancreatic tail. 3.There is a a slightly blunted response to secretin.4.Enhancing right adrenal nodule, which does not meet criteria for an adenoma. The differential diagnosis includes metastatic disease (given history of previous renal cell carcinoma) or a small pheochromocytoma.5.Cholelithiasis.