52-year-old female status post laparoscopic cholecystectomy in 2013 with congenital biliary malrotation. With persistent abdominal pain, and intermittent fevers and chills. ABDOMEN:LIVER, BILIARY TRACT: Left hepatic cyst. Again seen are postsurgical changes of a Roux-en-Y hepaticojejunostomy, similar to prior. Likely preduodenal portal vein.SPLEEN: Polysplenia.PANCREAS: Again seen are postsurgical changes of a Roux-en-Y hepaticojejunostomy, with the pancreas deviated into right abdomen. The pancreatic duct is normal in caliber, with drainage into the medial aspect of the duodenum visualized. There is normal excretion witnessed after secretin injection. The head of the pancreas has an abnormal position anteriorly, with separate drainage into the duodenum. The tail of the pancreas is not seen, which may be congenital.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: Right renal sinus cyst. Azygos continuation of the IVC, better visualized on the prior CT.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality noted.
1. Postsurgical changes of a Roux-en-Y gastrojejunostomy and biliary hepatojejunostomy, without acute abnormality.2. Normal pancreatic response to secretin.