Prior Whipple for IPMN. Cystic lesion in pancreatic genu. Evaluate for stricture versus cyst. ABDOMEN:LIVER, BILIARY TRACT: Right hepatic lobe simple appearing cysts. No suspicious lesion. No intrahepatic biliary ductal dilatation. The vessels are patent.The common hepatic duct measures 6 mm, similar to prior.Trace perihepatic fluid adjacent to the anterior liver margin, not significantly changed.The hepatic vasculature is patent.SPLEEN: The spleen is normal in size measuring 11.9 cm in length without a focal lesion.PANCREAS: Postsurgical changes from Whipple procedure. There is loss of intrinsic T1 weighted signal intensity of the pancreas. The pancreas enhances homogeneously without a discrete lesion.No evidence of acute pancreatitis.The residual pancreatic body and tail is moderately atrophic with irregular main pancreatic ductal dilatation up to 7 mm to the level of the pancreaticojejunostomy anastomosis. There is side branch ectasia. The appearance is similar to that seen previously. No suspicious postcontrast enhancement.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: Bilateral simple appearing cystsRETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Postsurgical changes from Roux-en-Y. Status post colectomy. BONES, SOFT TISSUES: Mid/lower thoracic vertebral body stable hemangiomata.OTHER: No significant abnormality noted.
Relatively stable post Whipple surgical changes. Significant pancreatic ductal dilatation without a discrete mass lesion, appearing similar to prior. This may be related to an anastomotic stricture and less likely a main duct IPMN.