78-year-old male with history of pancreatic mass status post distal pancreatectomy. Evaluate for recurrence. ABDOMEN:LIVER, BILIARY TRACT: There are focal areas of bilobar intrahepatic biliary ductal dilatation. The extrahepatic biliary ducts are unremarkable.SPLEEN: No significant abnormality noted.PANCREAS: Postoperative changes of distal pancreatectomy. There is a heterogeneous lesion located near the resection site measuring 5.7 x 3.3 cm with no appreciable enhancement.5 mm cystic lesion without enhancement at the pancreatic body measures 5 mm. A similar appearing cystic lesion is present slightly more distally measuring 3 mm.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: Stable bilateral simple cysts.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: Large hiatal hernia
1. Heterogeneous lesion near the distal pancreatectomy resection site is nonspecific, but suspected to reflect postoperative changes with a tethered loop of jejunum. Subsequent followup should be obtained with CT abdomen/pelvis to confirm. No evidence of disease recurrence otherwise.2. Pancreatic cystic lesions as above likely representing tiny IPMNs.