History of abdominal pain nausea and vomiting. Pancreatic dilatation seen on ultrasound. ABDOMEN:LIVER, BILIARY TRACT: The common bile duct and pancreatic duct are dilated to the level of the ampulla where they taper smoothly. No discrete masses evident on this limited noncontrast examination. No filling defects to suggest a stone. Normally distended gallbladder. Several well-defined T2 weighted hyperintense liver foci likely represent benign hepatic cysts.SPLEEN: No significant abnormality noted.PANCREAS: 1.6 x 1.2 cm distal pancreatic tail T2-weighted hyperintense lobular mass without definite communication with the pancreatic duct. Pancreatic ductal dilatation with smooth tapering at the level of the ampulla.ADRENAL GLANDS: 3.3 x 2.0 cm smoothly marginated right adrenal homogeneous mass demonstrating signal dropout on out of phase imaging likely representing a lipid rich adrenal adenoma. Mildly thickened left adrenal gland.KIDNEYS, URETERS: Numerous bilateral well-defined T2 hyperintense and intermediate intensity foci are incompletely characterized without contrast, likely representing multiple cysts.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: Incompletely characterized the left lower lobe pulmonary nodule.
1.1.6 cm distal pancreatic tail cystic mass may represent and intraductal pancreatic mucinous neoplasm (IPMN) however a mucinous cystadenoma/cystadenocarcinoma remains a possibility.2.Biliary ductal and pancreatic ductal dilatation to the level of the ampulla without a discrete mass lesion evident on this limited noncontrast examination or gallstone. If this remains of concern an ERCP should be considered.3.Incompletely characterized left lower lobe pulmonary nodule. A dedicated CT examination is recommended.4.Lipid rich right adrenal adenoma.5.Incompletely characterized renal lesions likely represent multiple cysts.Incidental left lung nodule and recommendation for a dedicated CT of the chest was relayed to the ordering physician (Dr. Marc Robinson) using the paging system at 1356 on 08/04/2015.