Hypoglycemia (Persistent low blood sugars, without hx of diabetes). Evaluate for insulinoma. ABDOMEN:LIVER, BILIARY TRACT: Layering gallstones within the gallbladder without evidence of cholecystitis. The common bile duct is normal in caliber. There is a prominent 3.1 x 2.9 cm projection adjacent to the caudate lobe that follows signal intensity of the liver on all sequences, compatible with a papillary process of the liver, normal variant.SPLEEN: No significant abnormality noted.PANCREAS: There is an enhancing lesion within the pancreas that is T2 hyperintense and restricts diffusion measuring 2.5 x 1.9 cm (series 6, image 22). The pancreatic duct is not well-visualized, but is not grossly dilated.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: Left lower lobe atelectasis. Suggestion of trace bilateral pleural effusions.
1.Enhancing mass in the pancreas as described above, likely an insulinoma given clinical history.2.Cholelithiasis, without evidence of cholecystitis.