67-year-old man status post Roux-en-Y for pancreatic transection with increased JP output with high fluid amylase and fistula formation noted on recent fluoroscopic drainage. ABDOMEN:LIVER, BILIARY TRACT: There is mild to moderate intrahepatic biliary duct dilatation, the liver is otherwise unremarkable. The biliary-enteric anastomosis appears patent.SPLEEN: No significant abnormality noted.PANCREAS: The pancreas is atrophic. The proximal and distal pancreatic ducts are visualized, however the midportion of the duct is not seen. The visualized pancreatic duct is normal in caliber.Of note, there is a thin tract of T2 signal extending from the pancreatic duct in the neck into a portion of the abdominal fluid collection (series 701, images 79-90).ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: Bilateral renal cysts are noted. The kidneys are otherwise normal.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Patient is status post Billroth II and has percutaneous gastrostomy. An abdominal drain is seen crossing the midline with pigtail anterior to the pancreatic head and the volume of fluid in the lesser sac has decreased from the CT on 10/23/2015.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: There are bilateral small pleural effusions.
1.Probable thin communication between the pancreatic duct in the neck of the pancreas to the abdominal fluid collection.2.Abdominal drain in place with decreased fluid.