Reason: further evaluate pancreatic changes noted on recent CT History: abdominal pain, anorexia ABDOMEN: Suboptimal examination due to motion artifact of several sequences. LIVER, BILIARY TRACT: The liver is enlarged measuring 23 cm in craniocaudal dimension, which may be due to a normal variant Riedel lobe. No focal hepatic lesion. No intrahepatic or extrahepatic biliary ductal dilatation. No gallstones. SPLEEN: No significant abnormality noted.PANCREAS: Fullness and mild restricted diffusion of the pancreatic head with marked fatty atrophy of the body and tail. There is diffuse decreased enhancement of the pancreatic head relative to the remainder of the pancreas, raising the question of parenchymal necrosis. No discrete abnormal fluid collection. No pancreatic mass identified. No pancreatic ductal dilatation. Peripancreatic and perigastric enlarged lymph nodes are unchanged and likely reactive.The SMV-portal vein junction is narrowed, although patent. No vascular complication. ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Postsurgical changes of the stomach. BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.
Fullness of the pancreatic head with associated likely reactive lymphadenopathy compatible with history of pancreatitis. Diffuse decreased enhancement of the pancreatic head raises the question of parenchymal necrosis. Recommend short term follow-up to resolution. 