Abdominal pain status post endoscopic ultrasound. Elevated LFTs and jaundice. ABDOMEN:LIVER, BILIARY TRACT: Mild intra and moderate extrahepatic biliary ductal dilatation with the common duct measuring 1.2 cm. The duct tapers abruptly at the level of pancreatic head. The liver is normal in morphology, signal intensity and enhancement. The vessels are patent. No focal suspicious liver lesion.SPLEEN: Moderate splenomegaly with the spleen measuring 15.4 cm in craniocaudal dimension.PANCREAS: The pancreatic duct is mildly prominent measuring up to 5 mm. It abruptly terminates at the level of the pancreatic head. There is heterogeneous edematous enlargement of the pancreatic head which demonstrates heterogeneous T2-weighted signal intensity and subtle differential enhancement relative to the remainder of the pancreatic parenchyma. There are adjacent inflammatory changes, compatible with focal acute pancreatitis.Within the pancreatic head at the level of the abrupt pancreatic and bile duct narrowing there is a 1.3 x 1.4 cm mildly T2 hyperintense and restricting lesion (series 501/17), suspicious for a neoplasm. There is minimal enhancement of the lesion.There is a very small intrapancreatic fluid collection more inferiorly (series 501/13).There is no soft tissue encasement of the celiac axis or superior mesenteric artery. The portal vein, splenic vein and superior mesenteric vein appear patent. Periportal lymph node measuring 8 mm in short axis.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: Subcentimeter right renal superior pole cyst.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: Small volume ascites. Bilateral mild discoid atelectasis. Small pleural effusions. Mild body wall edema.OTHER: No significant abnormality noted.
1. Findings compatible with mild focal pancreatitis of the pancreatic head with a very small intrapancreatic fluid collection.2. 1.4 cm pancreatic head lesion with associated pancreatic and biliary ductal dilatation suspicious for a neoplasm, including a cystic islet cell tumor or pancreatic adenocarcinoma.3. Splenomegaly of uncertain etiology. 4. Small pleural effusions and small volume ascites.