Reason: 52 yo M w/ pancreatic ductal dilation and fluid collection on CT scan. ERCP 5/26 w/ pancreatic duct stricture unable to be bypassed. MRI/MRCP w/ secretin to assess pancreatic duct History: pancreatic duct stricture, pancreatic fluid collection ABDOMEN:LIVER, BILIARY TRACT: Subcentimeter T2 hyperintensities, likely cysts.SPLEEN: The splenic vein is narrowed but appears patent. There are multiple perisplenic collateral vessels.PANCREAS: Peripancreatic fluid collection in the region of the pancreatic neck is slightly decreased in size measuring 3.3 x 2.1 cm (501/22), previously 3.6 x 2.1 cm. An adjacent collection more distal adjacent to the lesser curvature of the stomach has nearly resolved (501/24), previously measuring 3.4 x 3.4 cm.There is main pancreatic duct throughout the tail of the pancreas with stricturing within the pancreatic body. The distal pancreas is atrophic and has low T2 signal with diffusion restriction and hyperenhancement, suggesting chronic pancreatitis. A blunted response to seek attention is also observed, also supporting findings of chronic pancreatitis.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: 4.6 cm left midpole cyst.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.Peripancreatic fluid collections have decreased in size since the prior exam.2.Stricturing of the main pancreatic duct within the pancreatic body and associated dilatation within the pancreatic tail.3.Findings of chronic pancreatitis of the pancreatic tail with a blunted response to secretin.