Stated history of celiac disease with intermittent diarrhea and abdominal pain. Evaluate for wall thickening for subsequent tissue sampling. ABDOMEN:LIVER, BILIARY TRACT: No intrahepatic or extrahepatic biliary ductal dilatation. No suspicious liver lesion. Portal vein and SMV thrombosis with multiple porta hepatis, perisplenic and gallbladder fossa collateral vessels. Gastric and esophageal varices.SPLEEN: Mildly prominent spleen measuring 14 cm in length.PANCREAS: Pancreatic tail cystic lesion measuring 1.6 x 1.5 cm, slightly increased from recent prior study without communication with the main pancreatic duct which is normal in caliber.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: Mildly prominent small bowel mesenteric lymph nodes are noted.BOWEL, MESENTERY: There is suboptimal small bowel distention by oral contrast. There may be an increased number of folds in the ileum. There is diffuse small bowel wall thickening, predominately of the jejunum, which may be in part due to under-distension. There is no significant asymmetric postcontrast enhancement or restricted diffusion. No significant bowel dilatation. Small volume of abdominopelvic ascites.
1. Diffuse small bowel wall and fold thickening without significant enhancement or restricted diffusion, increased number of folds in ileum suggested.2. 1.6 cm pancreatic body/tail cystic lesion without definite communication with the normal caliber main pancreatic duct. No suspicious post-contrast enhancement. Given the short-interval development of this cystic lesion a pseudocyst is suggested; however, correlation with the patient's clinical history and follow-up to resolution is advised.