Concern for biliary obstruction. ABDOMEN:LIVER, BILIARY TRACT: The liver is normal in size and contour. The gallbladder is partially contracted without wall thickening or adjacent inflammatory changes. No gallstones. No intra or extrahepatic biliary ductal dilatation, choledocholithiasis or discrete mass lesion is evident, within the limitations of a non-contrast examination.A posterior segment 4.1 x 2.2 cm T2 hyperintense lesion is noted. On the CT dated 8/10/2012 this lesion demonstrated peripheral discontinuous nodular enhancement consistent with a hemangioma.Additional small focus of T2-hyperintense branching signal in segment IVb is favored to be a benign lesion such as an AVM as it is suspected to have been present on the CT from 5/2006 (series 5, image 38).SPLEEN: The spleen is normal in morphology signal intensity and size without a discrete lesion.PANCREAS: In the pancreatic head there is a 1.6 x 0.5 cm cystic lesion which appears to communicate with the main pancreatic duct. Additional cystic lesion measuring 7 x 9 mm in the pancreatic body/tail junction also appears to communicate with the main pancreatic duct. These likely represent side branch IPMNs. The main pancreatic duct is normal in caliber. The pancreatic parenchyma is otherwise normal in appearance.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Dilated small bowel loop in the right lower quadrant, not significantly changed from the CT dated 5/13/2015, likely related to prior small bowel surgery. It contains fecaliths compatible with stasis.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.
1.No biliary ductal dilatation, obstructive stone or discrete lesion is evident. Evaluation for a mass lesion is limited by lack of intravenous contrast.2.Small cystic pancreatic lesions likely represent a sidebranch IPMNs.3.Dilated small bowel loop in the right lower quadrant, similar to prior CT containing fecaliths indicating stasis. This may be post-operative in etiology.