Male; 77 years old. Reason: 77M Extensive hx of pancreatobiliary complications and interventions s/p chole 2012 with biliary stent for bile leak, ERCP pancreatitis 2014 c/b pseudocyst, and 1/2015 cysto-gastrostomy stent to drain the pseudocyst. s/p ERCP 3/18/15 for stent exchange History: pancreatic pseudocyst ABDOMEN:LUNG BASES: Stable persistent right basilar nonspecific atelectasis/consolidation. Trace right pleural effusion.LIVER, BILIARY TRACT: Stable subcentimeter left hepatic cyst. Status-post cholecystectomy.Stable mild dilation of the common bile duct measuring up to 8 mm with distal smooth tapering. Stable mild intrahepatic biliary ductal dilatation.SPLEEN: No significant abnormality noted.PANCREAS: Previously seen 1.7 x 1.1 cm peripancreatic fluid collection at the junction of the body and tail has resolved. No new peripancreatic fluid collections. Previously seen AXIOS cystogastrostomy stent has been removed. Double-pigtail plastic biliary stent placed during ERCP on 3/18/15 is not visualized.Mild pancreatic parenchymal atrophy is seen at the junction of the body and tail with loss of normal T1 signal in the distal body and tail, suggestive of chronic pancreatitis.The pancreatic duct within the head and downstream body appears normal. Again, there is a short segment of the pancreatic duct at the junction of the upstream body and tail that is not well visualized, which could be related to underlying stricturing. Slight prominence of the upstream pancreatic duct in the tail with some side branches visualized, which can be seen in chronic pancreatitis.Normal physiologic response to secretin.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: Stable renal cysts.RETROPERITONEUM, LYMPH NODES: IVC filter. Mild amount of mural thrombus in the aorta.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.
1.Interval resolution of peripancreatic fluid collection. No new peripancreatic fluid collections.2.Findings suggestive of mild chronic pancreatitis with possible stricturing of the pancreatic duct at the body/tail junction, as detailed above. Normal physiologic response to secretin.3.Stable persistent right basilar nonspecific atelectasis/consolidation, though continued CT follow-up is recommended.