Reason: Pt s/p whipple for ampulla IPMN 12/2014. Post-op course complicated by pancreatic duct leak. Pt is s/p EIS guided pancreatico-gastrostomy 3/2015. Pt with persistent wound drainage. Secretin Stimulating MRCP History: Persistent wound drainage. ABDOMEN:LIVER, BILIARY TRACT: Postsurgical changes of a Whipple procedure. Mild intrahepatic biliary ductal dilatation, unchanged.SPLEEN: No significant abnormality noted.PANCREAS: Postsurgical changes of a Whipple procedure. Prominent pancreatic duct measuring up to 4 mm, unchanged. Focal stricturing immediately proximal to the anastomosis is unchanged. New focal stricture at the level of the body (series 1701 image 1). Interval resolution of previously seen probable pancreatitis. Previously seen small fluid collection along the inferior margin of the liver has increased in size, measuring 4.7 x 2.6 cm (series 601 image 11), previously 2.4 x 2.0 cm. This collection appears to communicate with the pancreatic-jejunal anastomosis. Previously seen drain entering this collection has been removed in the interval. ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: Bilateral renal cysts.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: Focal abnormal signal involving the anterior abdominal wall may represent cellulitis. No abnormal fluid collection to suggest abscess. OTHER: No significant abnormality noted.
1.Interval increase in size of abnormal subhepatic collection with interval removal of percutaneous drain.2.Stable prominent pancreatic duct with stable proximal stricture. New stricture at the level of the body.3.Interval resolution of diffuse pancreatic inflammation. 4.Focal anterior abdominal wall inflammation. Correlate with cellulitis. No evidence of abscess. 