50-year-old male with history of gallstone pancreatitis status post laparoscopic cholecystectomy in March 20, 2016. Patient now with pseudocyst with IR drainage. Evaluate pseudocyst and pancreatic ductal anatomy. ABDOMEN:LIVER, BILIARY TRACT: No suspicious hepatic lesions. The mid to distal common bile duct extending over a region of approximately 1.5 cm is now well opacified, likely secondary to inflammatory changes as detailed below. The proximal bile duct is dilated up to 1.0 cm; additionally, there is mild intrahepatic biliary ductal dilatation.SPLEEN: No significant abnormality noted.PANCREAS: There is increased T2 signal diffusely throughout the pancreas and peripancreatic tissues compatible with history of pancreatitis. Intrinsic T1 hyperintense signal is maintained throughout the pancreatic head, uncinate process, pancreatic body, and pancreatic tail.There is a complex rim-enhancing multiloculated fluid collection that insinuates the pancreas; predominantly, this fluid collection extends posteroinferiorly towards the liver. It additionally extends posteriorly towards the spleen and anterior inferiorly to the pancreas. The anterior inferior component measures 6.5 x 5.3 cm (series 1301, image 40) and the posterior component measures approximately 9.5 x 3.4 cm (series 1301, image 78). This fluid collection is best seen on the postcontrast arterial images 362; all the components are noted to be connected to each other.Suboptimal secretin images were obtained.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: Right renal cyst.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: Trace bilateral pleural effusions.
1.Findings consistent with pancreatitis and complex multiloculated rim-enhancing peripancreatic fluid collection as detailed. Normal intrinsic T1 hyperintense pancreatic signal is maintained.2.Suboptimal secretion images were obtained; however, the pancreatic duct is smooth throughout with minimal smooth prominence to 3 mm in the pancreatic head without evidence of a mass/stricture.3.Narrowing of the mid common bile duct likely from extrinsic inflammatory changes resulting in mild extra and intrahepatic biliary ductal dilatation.