72-year-old female status post Whipple's procedure in 2014 for IPMN now with recent elevation of LFTs, nausea, and vomiting. ABDOMEN:LIVER, BILIARY TRACT: 2.1 x 1.3 cm segment 6 mildly T2 hyperintense lesion with mild peripheral enhancement which slightly increases on delayed phase images, most likely an atypical hemangioma (series 13/57). No suspicious hepatic lesions are evident on this nondedicated study.Gallbladder surgically absent. Marked intra and extrahepatic biliary ductal dilation with the common bile duct measuring up to 1.4 cm (series 5/1) with abrupt transition at the biliary enteric anastomosis, most suspicious for stricture. Small amount of dependent low T2, high T1 signal within the distal common bile duct, most likely due to biliary sludge.SPLEEN: No significant abnormality noted.PANCREAS: Postsurgical changes from Whipple's procedure. Remaining pancreas is atrophied with main pancreatic ductal dilation measuring up to 10 mm (series 5/1) and multiple dilated side branches visualized. There is an abrupt transition at the pancreatic enteric anastomosis, for which stricture cannot be excluded.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.
Pancreaticobiliary tree dilation status post Whipple's procedure. Stricture at the biliary enteric anastomosis is suspected. Stricture at the pancreatic enteric anastomosis is also a possibility, though clinical correlation for such would be needed, comparison to prior imaging if available may be helpful.