63-year-old man with history of distended pancreatic duct on outside CT. ABDOMEN:LIVER, BILIARY TRACT: The liver is normal in signal and morphology. The gallbladder is normal.SPLEEN: The spleen is normal.PANCREAS: The body and tail of the pancreas are markedly atrophied and the pancreatic duct is irregularly dilated with numerous dilated side branches (series 7, image 62). Small filling defects are noted including a 10 mm defect in the duct of the pancreatic body which is unchanged from the comparison outside examination (series 3, image 16). No mass lesion is identified.ADRENAL GLANDS: Bilateral fat-containing adrenal nodules are likely adenomas.KIDNEYS, URETERS: There is moderate left hydronephrosis with proximal hydroureter. Layering debris is seen in some of the dilated calyces. No enhancing renal masses identified, however the mid and distal ureters are not visualized. The right kidney appears normal.RETROPERITONEUM, LYMPH NODES: No significant lymphadenopathy noted.BOWEL, MESENTERY: The partially visualized small bowel and colon are normal.BONES, SOFT TISSUES: Small perineural cysts are noted in the lower thoracic, upper lumbar, and sacral spine. Median sternotomy sutures are noted.OTHER: No significant abnormality noted.
1.Atrophy pancreatic body and tail with ductal dilatation and small filling defects. No discrete mass is seen. These findings are similar to the prior, outside examination and may be due to a small obstructing lesion, benign stricture, or main duct IPMN. CT can be considered for further evaluation and identification of possible intraductal calcification.2.Left hydronephrosis with proximal hydroureter similar to the prior, outside study. The mid and distal ureters are not visualized.