53 years, Female, Reason: 52F s/p lap CCY 8/2013 with congenital biliary malrotation, recurrent abdominal pain History: Abdominal pain, chills, monthly rigors. ABDOMEN:LUNG BASES: No significant abnormality notedLIVER, BILIARY TRACT: Left hepatic cyst. Postsurgical changes of a Roux-en-Y hepaticojejunostomySPLEEN: Polysplenia.PANCREAS: There are postsurgical changes of a Roux-en-Y hepaticojejunostomy. Pancreas deviated into right abdomen. Normal pancreatic ductal caliber seen, drainage into the medial aspect of the duodenum visualized. The head of the pancreas has an abnormal position anteriorly draining separately into the duodenum. There may be mild decreased T1 signal within the tail of the pancreas. There is no apparent response to secretin administration.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: Right renal sinus cyst. Azygos continuation of the IVC.BOWEL, MESENTERY: Perihepatic fluid collection seen on prior CT is no longer visualized. Mildly prominent bowel loops without evidence of obstruction.BONES, SOFT TISSUES: No significant abnormality noted.
1.Postsurgical changes of Roux-en-Y gastrojejunostomy with resolution of peripancreatic fluid collection.2.Absent response to secretin administration suggests severe exocrine dysfunction.