History of cholecystectomy with epigastric pain and elevated lipase. Normal CT. EGD demonstrated gastritis, possible pancreas divisum and pancreatic parenchymal abnormalities. ABDOMEN:LIVER, BILIARY TRACT: Prominent Riedel's lobe. Otherwise normal hepatic morphology without a discrete lesion. The patient is status post cholecystectomy. The common bile duct is dilated up to 11 mm with mild intrahepatic biliary ductal dilatation. The common bile duct tapers smoothly at the level of the pancreatic head without a discrete mass lesion, favoring a benign stricture, measuring approximately 2.4 cm. The liver demonstrates mild signal loss on out of phase imaging compatible with diffuse fatty infiltration.SPLEEN: 2.0 cm T2 hyperintense non-enhancing splenic lesion, compatible with a cyst. PANCREAS: The main pancreatic duct is prominent up to 4 mm. At the level of the pancreatic head it appears to taper smoothly for approximately 4 cm to the major ampulla without shouldering or discrete lesion, again favoring a benign stricture (series 3 images 25-27). The pancreatic parenchyma demonstrates normal intrinsic T1-weighted signal intensity aside from mild decrease in the pancreatic head. The pancreas enhances homogeneously. Following secretin administration there is prompt voluminous excretion into the small bowel suggesting intact exocrine function. The main pancreatic duct does not demonstrate significant increase in caliber suggesting decreased compliance and there appears to be subtle side branch ectasia, findings suggesting chronic pancreatitis.Punctate foci of T2 weighted hyperintensity likely represent sites of side branch ectasia as opposed to IPMNs.The minor duct is not well visualized. ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: Subcentimeter right renal cyst. No hydronephrosis or suspicious lesion.RETROPERITONEUM, LYMPH NODES: Infrarenal abdominal focal ectasia measuring up to 2.8 cm in AP dimension.BOWEL, MESENTERY: Diverticulosis.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: Basilar consolidation and/or atelectasis.
1.No specific findings of pancreas divisum.2.Benign nonflow-limiting strictures of the common bile duct and main pancreatic duct at the level of the pancreatic head without a filling defect or mass lesion evident. 3.Intact pancreatic parenchymal exocrine function. However, there is decreased main pancreatic duct compliance and side branch ectasia, consistent with sequela of chronic pancreatitis, no evidence of acute inflammation.4.Infrarenal abdominal aorta ectasia.5.Basilar consolidation.