History of chronic pancreatitis and IPMN status post distal pancreatectomy and splenectomy. Evaluate for recurrence. 11/25/2009 Pathology demonstrated side-branch IPMN and chronic pancreatitis. ABDOMEN:LIVER, BILIARY TRACT: The liver is normal in morphology and size measuring 17 cm in craniocaudal dimension. No focal suspicious lesion. No vascular abnormality.Lobular dilatation of the common bile duct is not significantly changed in caliber or morphology without a filling defect, stricture or mass lesion. Minimal central intrahepatic ductal dilatation, unchanged.Normally distended gallbladder.SPLEEN: Status post splenectomy.PANCREAS: Postsurgical changes from distal pancreatectomy. The main pancreatic duct is mildly irregularly prominent up to 4 mm, slightly improved from prior. There is mild side branch ectasia and several punctate subcentimeter T2 hyperintensities in the parenchyma without definitive communication with the main pancreatic duct.No suspicious postcontrast enhancement. The pancreatic parenchyma has diminished intrinsic T1-weighted signal intensity but demonstrates homogeneous postcontrast enhancement. No specific findings of acute pancreatitis.ADRENAL GLANDS: Stable small left lipid rich adrenal adenoma.KIDNEYS, URETERS: At least partially duplicated collecting system on the right. No hydroureteronephrosis or suspicious lesion.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: Large perineural cyst/Tarlov cysts in the partially imaged sacrum, unchanged dating back to 2013.OTHER: No significant abnormality noted.
1. Interval mild decrease in residual pancreatic ductal irregular dilatation without a focal lesion evident, likely stigmata of chronic pancreatitis.2. Stable punctate cystic pancreatic parenchymal foci without definitive communication with the main pancreatic duct may represent small side branch IPMNs vs other tiny cystic lesions. No suspicious imaging characteristics.