History of acute pancreatitis with pseudocyst formation. Evaluate for underlying mass. ABDOMEN:LIVER, BILIARY TRACT: The liver is normal in signal and morphology. No focal lesions evident. There is mild intrahepatic and moderate extrahepatic biliary ductal dilatation. The common bile duct measures 16 mm in diameter.SPLEEN: No significant abnormality noted.PANCREAS: Findings of acute pancreatitis poorly defined edema involving the pancreatic head and proximal body as well as the peripancreatic soft tissues. The pseudocyst within the pancreatic head is decreased compared to prior. There is mild prominence of the main pancreatic duct extending to the level of the pseudocyst. No definite mass lesion, however the exam is limited by the ongoing inflammatory changes of pancreatitis and the lack of intravenous contrast.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: Atrophic kidneys bilaterally within numerable small cysts compatible with acquired cystic disease. No hydronephrosis. No definite mass within the limits of a noncontrast exam.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: New perihepatic ascites extending into the right paracolic gutter.
1.Findings of acute pancreatitis involving the head and proximal body of the pancreas. The patient's known pseudocyst in pancreatic head is decreased in size compared to prior. There is an increasing amount of perihepatic ascites.2.Persistent prominence of the pancreatic duct extending to the level of the patient's pseudocyst. No definite underlying mass lesion, however exam is limited by the extensive inflammatory changes of ongoing pancreatitis and the lack of intravenous contrast. Consider a repeat exam after the pancreatitis has resolved for further evaluation.3.Persistent mild intrahepatic and moderate extrahepatic biliary ductal dilatation extending to the level of the ampulla.