72-year-old woman with history of portal vein thrombosis and cystic pancreatic lesions on ultrasound. ABDOMEN:LIVER, BILIARY TRACT: The liver is cirrhotic in morphology with nodular contour and relative atrophy of the right lobe compared to the hypertrophic left lobe. No suspicious focal enhancing hepatic lesions identified.The main, right, and proximal left portal veins are patent. The lateral left portal vein is small but patent (1204/223). The medial left portal vein is patent and feeds a large paraumbilical collateral vein.The gallbladder appears normal. There is no intra or extrahepatic biliary ductal dilatation.SPLEEN: There is splenomegaly. The spleen is otherwise normal.PANCREAS: Multiple cystic lesions are noted in the pancreas without enhancement and without clear communication to the pancreatic duct (MRCP images are significantly degraded due to motion). The main pancreatic duct is nondilated. The remainder of the pancreatic parenchyma appears normal.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: Paraumbilical and retroperitoneal/perisplenic collaterals seen. The left renal vein and left gonadal vein are dilated, definitive renal vein to splenic vein communication not able to be visualized.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Circumferential gastric wall thickening is nonspecific in the setting of ascites.BONES, SOFT TISSUES: There is soft tissue anasarca.OTHER: Ascites noted. There is cardiomegaly.
1.Cirrhotic morphology of liver without suspicious focal hepatic lesion.2.Patent portal veins. Evidence of portal hypertension with splenomegaly and paraumbilical and retroperitoneal/perisplenic collaterals. 3.Multiple cystic pancreatic lesions, likely side branch IPMNs.