Reason: Pt with know h/o Pancreatic Divisum and multiple bouts of pancreatitis requiring several ERCPS with stents. Need SECRETIN Stimulating MRCP to evaluate. History: Chronic abdominal pain ABDOMEN:LIVER, BILIARY TRACT: The liver parenchyma demonstrates normal signal intensity. There is a subcentimeter T2 hyperintense focus within segment 6 (series 4, image 16) which demonstrates persistent enhancement and is compatible with a hemangioma. There are several additional peripheral wedge-shaped areas of arterial enhancement without washout which are compatible with transient hepatic intensity differences. No suspicious focal hepatic lesions are identified. The gallbladder is surgically absent. There is no intra or extrahepatic biliary ductal dilatation. The hepatic vasculature appears patent.SPLEEN: No significant abnormality noted.PANCREAS: The pancreas demonstrates diffusely decreased T1 signal as well as diffuse mild atrophy compatible with chronic pancreatitis. The pancreatic duct is mildly irregular with scattered strictures and is mildly prominent in caliber measuring up to 5 mm at the level of the pancreatic head. The main pancreatic duct empties into the minor papilla compatible with pancreatic divisum. There appear to be several small connections between the main pancreatic duct and the distal common bile duct. No pancreatic duct stones are identified. Post secretin images demonstrate a blunted/poor response to secretin possibly due to pancreatic duct stricturing.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: No significant abnormality noted.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.Pancreas divisum. 2.Findings compatible with chronic pancreatitis including mild prominence, irregularity, and stricturing of the main pancreatic duct. No evidence of acute pancreatitis.3.Blunted/poor response to secretin possibly due to pancreatic duct stricturing.