Recurrent pancreatitis with history of strictures. Please note that the study is limited as it was truncated early due to patient lack of cooperation. As a result post contrast secretin images and in phase out of phase images were not obtained. Due to patient motion the postcontrast images are nondiagnostic. The coronal T2 images are the most diagnostic images obtained.ABDOMEN:LIVER, BILIARY TRACT: The liver is normal in morphology and size. No discrete suspicious lesion is evident within the limitations described above. Cholelithiasis within a normally distended gallbladder. No intra or extrahepatic biliary ductal dilatation. A common bile duct stent is suspected.SPLEEN: No significant abnormality noted.PANCREAS: The pancreas is atrophic. The main pancreatic duct is significantly dilated up to 10 mm with side branch ectasia at the tail. It transitions near the pancreatic head. In the adjacent uncinate process/pancreatic head there is a lobular multiseptated lobular cystic lesion measuring approximately 2.4 x 1.4 cm in cross section (series 401/10). Communication with the main pancreatic duct is not definitive due to motion.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Colonic diverticulosis. Small volume perihepatic and perisplenic ascites.BONES, SOFT TISSUES: Anasarca. Mild superior endplate deformities of the lower thoracic and lumbar spine.OTHER: At least moderate pleural effusions with compressive atelectasis.
1.Limited examination due to patient's motion and as above.2.Significant dilatation of the main pancreatic duct with pancreatic atrophy and side branch ectasia to the level of the pancreatic head where there is a lobular multiseptated cystic lesion without demonstrable communication with the main pancreatic duct. Correlation with EUS findings and tissue sampling is recommended. Enhancement is unable to be adequately assessed, and this lesion remains indeterminate.3.Anasarca, small volume ascites and moderate pleural effusions. Cholelithiasis within a normally distended gallbladder.