History of necrotizing pancreatitis complicated by pseudocyst formation status post internal drainage. ABDOMEN:LIVER, BILIARY TRACT: The liver is normal in size, signal intensity and enhancement. No focal suspicious lesion or biliary ductal dilatation. Fatty infiltration with focal fat sparing. Status post cholecystectomy.The common bile duct is normal in caliber.The portal vein is significantly narrowed and is slit-like just distal to the SMV splenic vein confluence, similar to that seen on the prior CT.SPLEEN: No significant abnormality noted. Splenic vein is patent.PANCREAS: In the region of the pancreatic body and proximal tail there is a fluid collection measuring 4.6 x 1.4 cm (series 5/19) with a cystogastrostomy stent in place. This is significantly decreased in size compared to the prior CT study where it measured 9.7 x 3.8 cm.There is mild decrease in intrinsic T1 weighted hyperintensity the pancreatic tail without peripancreatic inflammation, atrophy or pancreatic ductal dilatation.The pancreatic head is normal in T1-weighted signal intensity and enhancement and has a normal pancreatic duct caliber.Following secretin administration the pancreatic duct at the level of the pancreatic head demonstrates appropriate increase in caliber with increased excretion into the jejunum. The pancreatic duct in the pancreatic tail also becomes more visible on the post-secretin images, compatible with intact exocrine function. There is no evidence of obstruction, pancreas divisum, annular pancreas or choledocholithiasis. ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: Simple right renal superior pole cyst.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.Interval decrease in the intrapancreatic fluid collection/pseudocyst with cystogastrostomy stent in place.2.Slit-like narrowing of the portal vein just distal to the SMV-splenic vein confluence, appearing similar to the prior study.3.Appropriate exocrine response of the pancreatic head following secretin administration. The pancreatic duct in the pancreatic tail also becomes more visible on the post-secretin administration images, compatible with intact exocrine function. 4.No specific finding to explain the etiology of the patient's pancreatitis. 5.Fatty liver with focal fat sparing. 