History of autoimmune pancreatitis. ABDOMEN:LIVER, BILIARY TRACT: The liver is normal in morphology, size and signal intensity. The previously described peripheral filling defect in the mid common bile duct is less discernible on today's study where there appears to be mild stricturing of the common bile duct.There is also stricturing of the proximal common hepatic duct extending to Klatskin's point with associated intrahepatic biliary ductal dilatation, unchanged.No discrete lesion is evident.SPLEEN: No significant abnormality noted. Small caliber splenic vein with gastroepiploic collateral vessel formation.PANCREAS: Mild thickening of the pancreatic tail is similar to the prior study with a thin hypoenhancing rim, compatible with history of autoimmune pancreatitis. No peripancreatic fluid collection or inflammatory changes. The main pancreatic duct is not significantly dilated. On MRCP images it demonstrates irregular narrowing and dilatation with side branch ectasia.Small cystic lesion of the pancreatic head is unchanged and likely represents a sidebranch IPMN measuring 6 cm without suspicious imaging features.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.Decreased prominence of the peripheral filling defect in the mid common bile duct where there is a mild stricture. Unchanged appearance of the stricture involving Klatskin's point and associated intrahepatic biliary ductal dilatation. No discrete lesion is identified. Findings are compatible with history of autoimmune sclerosing cholangiopancreatitis. 2.Mild thickening of the pancreatic tail without evidence of acute inflammation, similar to prior study. Irregularly narrowed non-dilated main pancreatic duct with side-branch ectasia unchanged.3.Stable 6 mm pancreatic head probable side-branch IPMN.