59 year old female with a prominent pancreatic duct and intrahepatic ductal dilation. Presents with epigastric pain, nausea and vomiting. ABDOMEN:LIVER, BILIARY TRACT: Status post cholecystectomy. No evidence of significant intra- or extra-hepatic biliary ductal dilation. No focal mass lesion identified within the liver. SPLEEN: No significant abnormality noted.PANCREAS: The pancreas is mildly atrophic, intrinsic T1 signal of pancreas within normal limits. There is mild dilation of the main pancreatic duct measuring up to 6 mm in diameter, appearing similar to the findings on recent CT examinations. There is a normal exocrine response to secretin augmentation. However, the main pancreatic duct does not distend in response to secretin administration. This finding is nonspecific but is suggestive of chronic duct dysfunction. No definite pancreatic lesion delineated. A benign ductal stricture is also a differential consideration.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Postoperative changes of prior gastrojejunostomy. BONES, SOFT TISSUES: No significant abnormality noted.
1.Dilation of the main pancreatic duct with associated diminished response to secretin augmentation which may reflect chronic duct dysfunction. There is no focal obstructing masslesion identified, however, a benign stricture proximal to the confluence of the common trunk is not entirely excluded. Correlation with ERCP could be considered if clinically indicated. 