Reason: Hx of chronic pancreatitis, pancreatic pseduocyst History: Pancreatic pseudocyst. ABDOMEN:LIVER, BILIARY TRACT: Mild hepatic steatosis. Tiny punctate hepatic cysts in the right lobe of the liver. No suspicious focal hepatic lesion. No intrahepatic or extra hepatic biliary ductal dilatation. Post surgical changes of a cholecystectomy.SPLEEN: No significant abnormality noted.PANCREAS: Atrophic pancreas. Nonenhancing foci within the pancreas correlate with calcifications seen on outside CT. Pancreatic duct is mildly dilated measuring 4 mm. Multiple cystic lesions within the pancreas. The largest is multiloculated in the pancreatic body and measures approximately 1.6 x 3.8 x 2.1 cm (series 4 image 26, series 2 image 40), increased in size compared to outside CT. This lesion communicates proximally and distally with the pancreatic duct compatible with a main branch IPMN. Smaller pancreatic tail cystic lesions are also not significantly changed. These cystic lesions also appear to communicate with the pancreatic duct and likely represent side branch IPMN's. ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Additional cystic lesion adjacent to the pancreatic head measures 1.9 x 1.9 x 1.8 cm (series 4 image 32, series 2 image 43) and correlates with duodenal diverticulum on outside CT. BONES, SOFT TISSUES: Postsurgical changes of a sternotomy, which results in artifact on some sequences.OTHER: No significant abnormality noted.
1.Multiple pancreatic cystic lesions that appear to communicate with the pancreatic duct, which is mildly dilated. The largest in the pancreatic body has increased in size compared to prior outside CT and communicates proximal and distally with the pancreatic duct compatible with a main duct IPMN. Smaller lesions in the tail are likely side branch IPMN's.2.Chronic pancreatitis.3.Duodenal diverticulum. 4.Discussed with Dr. Waxman.