History of multiple episodes of pancreatitis, chronic abdominal pain, and multiple prior ERCPs with stent placements. ABDOMEN:LIVER, BILIARY TRACT: The liver is normal in signal and morphology. No focal parenchymal lesion.No intrahepatic or extrahepatic biliary ductal dilatation. The common bile duct measures 5 mm in diameter. Status post cholecystectomy. No evidence of stones or obstructing lesion.The hepatic vasculature is widely patent.SPLEEN: No significant abnormality noted.PANCREAS: The pancreas is normal in signal and morphology. The main pancreatic duct is normal in caliber. The duct has a tortuous course through the pancreatic head forming a loop, but no stricture is evident. The pancreatic duct joins the common bile duct at the level of the ampulla. No evidence of pancreatic divisum. There is no appreciable abnormality after administration of secretin in the duct itself, however the projection of evaluation is suboptimal. Fluid appears to increase in the duodenum after administration of secretin, implying good exocrine function, but again is suboptimal given the projection of post-secretin images. 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: Extensive susceptibility artifact in the thoracolumbar spine presumably related to spinal hardware. This limits evaluation of this region.OTHER: No significant abnormality noted.
1.Meandering main pancreatic duct (loop type) which joins the common bile duct at the level of the ampulla. Post-secretin changes described above.2.Normal appearance of the pancreatic parenchyma.