55-year-old female with history of tobacco and alcohol use, history of pancreatitis (2014) with abnormal MRCP, no follow-up ABDOMEN:LIVER, BILIARY TRACT: Cholelithiasis without evidence of cholecystitis. No focal liver lesions.SPLEEN: No significant abnormality noted.PANCREAS: Parenchymal atrophy with diffuse dilation of the main pancreatic duct measuring 6 mm in the mid body. No pseudocyst is present. Edema type signal surrounds the distal body and tail suggestive of a component of acute pancreatitis. There is a 4 mm filling defect within the distal dural pancreatic duct at the level of the ampulla that may represent a stone. Additional smaller filling defects are noted in the distal pancreatic duct. ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: No hydronephrosis.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: Subcentimeter T2 hyperintense lesions in the left L1 vertebral body is unchanged.OTHER: Right greater than left small pleural effusions. Small aneurysmal dilations of the branches of the GDA measuring 4 x 6 mm and 5 x 7 mm. Rind of T2 hypointense signal with mild enhancement surrounding the SMA is slightly increased since the prior examination.
1.Acute on chronic pancreatitis with small stones in the main pancreatic duct as described above. 2.Rind of T2 hypointense signal with mild enhancement surrounding the SMA is slightly increased since the prior examination may represent vasculitis or fibrosis.3.Small aneurysmal dilations of the branches of the GDA measuring 4 x 6 mm and 5 x 7 mm. Follow up is recommended - with a CTA4.Right greater than left small pleural effusions. 