Female 56 years old Reason: evaluate bilary ducts History: abdominal pain ABDOMEN:LIVER, BILIARY TRACT: Liver is normal in morphology but slightly enlarged. No suspicious hepatic lesions. Hepatic and portal veins are patent. Status post cholecystectomy. Common bile duct is dilated measuring 14 mm.SPLEEN: No significant abnormality noted.PANCREAS: Findings of severe chronic pancreatitis which distorts the underlying pancreatic duct. The pancreatic duct is dilated and multiple segments measuring up to 8 mm in the head of the pancreas. There are multiple calculi within the pancreatic parenchyma. There is a small collection in the pancreatic tail likely representing a pseudocyst measuring 2.1 cm. There is moderate inflammation involving the pancreas and its surroundings.The splenic vein is thrombosed. The superior mesenteric vein is thrombosed at the porta splenic confluence but is reconstituted by collaterals.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: Atrophy of the upper pole of the left kidney with mild hydronephrosis. The left renal vein is narrowed as it passes underneath the SMA due to pancreatic inflammation.RETROPERITONEUM, LYMPH NODES: IVC filter is in place.Multiple small peripancreatic lymph nodes.BOWEL, MESENTERY: No bowel obstruction is evident. There are mildly dilated upper abdominal loops of bowel with mild wall thickening possibly due to pancreatitis. No drainable fluid collections.BONES, SOFT TISSUES: Postsurgical changes in anterior abdominal wall.OTHER: Trace upper abdominal ascites.
1.Findings of a acute on chronic pancreatitis with a small pseudocyst in the pancreatic tail.2.Given the edema and enlargement of the pancreatic parenchyma a more focal neoplasm is not entirely excluded on this exam.3.Occlusion of the splenic vein and superior mesenteric vein near the porta splenic confluence.4.Common bile duct is mildly dilated.