History of acute pancreatitis in September 2015. ABDOMEN:LIVER, BILIARY TRACT: Marked hepatic steatosis. Hepatomegaly measuring 26 cm in the craniocaudal dimension. In the posterior segment of the right hepatic dome there is a 2.5 x 1.9 cm arterial enhancing wedge-shaped lesion which remains isointense on portal venous and delayed phase imaging. It is associated with T2-weighted hyperintensity and restricted diffusion. No signal loss of out-of-phase imaging. Otherwise, no focal suspicious liver lesion or biliary ductal dilatation. Normally distended gallbladder without gallstones.SPLEEN: Upper limits of normal splenic size measuring 13 cm in length without a focal lesion. It is normal in signal intensity.PANCREAS: The pancreas is normal in morphology. It is mildly decreased in intrinsic T1-weighted signal intensity with mild restricted diffusion but no significant peripancreatic inflammatory changes. The pancreas enhances homogeneously without evidence of parenchymal necrosis or other stigmata of acute pancreatitis. The main pancreatic duct is poorly seen at the level of the pancreatic head but there is no significant upstream dilatation. There appears to be adequate excretory response to secretin administration. ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.
1.Diffuse fatty infiltration of the liver puts the patient at risk for steatohepatitis. A focal hepatic dome lesion is likely benign, likely representing focal sparing.2. There is mild edema, restricted diffusion and loss of intrinsic T1-weighted signal intensity of the pancreas compatible with residua of acute pancreatitis. The main pancreatic duct is not well visualized at the level of the pancreatic head but without significant upstream dilatation which may reflect a subtle stricture, likely related to patient's pancreatitis. No significant peripancreatic inflammation, fluid collection, or arterial/venous complication. 