73-year-old male patient with acute pancreatitis. Evaluate for common bile duct stones. Evaluation is limited secondary to lack of IV contrast.ABDOMEN:LIVER, BILIARY TRACT: No intra or extrahepatic ductal dilatation. There is cholelithiasis without specific evidence of acute cholecystitis. No foci of signal void identified within the common bile duct to suggest choledocholithiasis. There is a heterogeneous mixed signal collection measuring 7.0 x 3.2 cm within the right hepatic lobe posterior to and displacing the posterior branch of the right portal vein adjacent to a large right suprarenal mass; this is new compared to the prior OSH MRI. The collection is septated, has a thin peripheral rim of T1 hyperintensity, and foci of susceptibility artifact, which may represent calcification or hemorrhage. This is favored to represent an intraparenchymal hematoma. SPLEEN: There is an accessory splenule. PANCREAS: The main pancreatic duct is not dilated with variant pancreatic ductal anatomy.ADRENAL GLANDS: There is a large right suprarenal mass measuring approximately 9.0 x 10.6 x 10.4 cm, appearing similar in size to the prior study, which causes mass effect on the adjacent liver and right kidney. The mass is heterogeneous in T2 signal with increased T2 hyperintensity centrally presumably representing necrosis, however, is incompletely characterized without IV contrast. The mass appears to compress the inferior vena cava anteriorly, but there is no definite invasion as best seen on the axial fiesta images. The right renal vein appears patent.The left adrenal gland is unremarkable.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: Large right pleural effusion and small left pleural effusion with overlying compressive atelectasis.
1.No intra- or extrahepatic biliary ductal dilatation. Cholelithiasis without evidence of acute cholecystitis.2.Large right suprarenal mass compatible with provided history of pheochromocytoma, though incompletely characterized without IV contrast.3.Interval development of a heterogeneous 7cm collection within the right hepatic lobe which is favored to represent an intraparenchymal hematoma given history of surgery since the prior OSH MRI. 