33 year-old female with a history of epigastric pain with fatty replacement of the pancreas and reportedly patulous appearing common bile duct on CT examination. ABDOMEN:LIVER, BILIARY TRACT: There is no intra- or extrahepatic biliary ductal dilation. No focal mass lesion identified. No gallstones are seen.SPLEEN: No significant abnormality noted.PANCREAS: The distal pancreatic body and tail are not well seen, which may represent severe fatty atrophy/replacement. The remainder of the pancreas also appears atrophic. Although assessment for calcifications would be better performed by CT examination, no definite signal abnormality is identified to suggest calcification. The main pancreatic duct is normal in size and appearance. No dilation or irregularity is identified.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: No evidence of lymphadenopathy.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.
Severe atrophy of the pancreas consistent with the stated history. No pancreatic or biliary ductal dilatation. If there is continued clinical concern, further evaluation with ERCP or MRI with administration of secretin recommended.