81-year-old male status post Whipple (8/24/2016) for ampullary cancer now with episodes of pancreatitis and questionable liver metastases. ABDOMEN:LIVER, BILIARY TRACT: The previously described segment 4A lesion is not identified on the current study. The previously described segment 6 lesion is again seen demonstrating low T1 signal and hypoenhancement best seen on portal venous phase (series 1104, image 378) relatively stable in size, measuring 12 x 10 mm. There is mild intrahepatic biliary ductal dilation.SPLEEN: No significant abnormality noted.PANCREAS: Postsurgical changes of the multiple are again seen. There is interval placement of a gastrojejunostomy tube causing artifact near the tail of the pancreas.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: Multiple renal cysts are again noted, unchanged.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Colonic diverticulosis is partially imaged. There is mild mucosal enhancement at the hepaticojejunostomy anastomosis which may be inflammatory. Segmental mucosal enhancement is also noted in the left lower quadrant, partially imaged. Improvement in ascites.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.
1.Previously described segment 4A lesion is not identified on the current study. The previously described segment six lesion is again seen and relatively stable in size when compared to the prior exam. Findings may represent a focus of resolving infection. Provided the lesions persistence in the interim, a small early metastatic focus still cannot be entirely excluded.2.Small bowel mucosal enhancement at the hepaticojejunostomy anastomosis and in the left lower quadrant (partially imaged) is nonspecific.