67 years, Female, Reason: 67F s/p whipple for intraampullary IPMN c/w pancreatic anastomotic leak History: pancreatic anastomotic leak. ABDOMEN:LUNG BASES: No significant abnormality notedLIVER, BILIARY TRACT: Postsurgical changes of Whipple procedure. Mild intrahepatic biliary ductal dilatation. Small fluid collection along the inferior margin of liver measuring 2.4 x 2.0 cm decreased from the prior CT where it measured 6.6 x 3.1 cm. Subtle intermediate T2 signal surrounding the collection suggests inflammation and delayed enhancement may indicate some degree of fibrosis. This collection appears to communicate with the main pancreatic duct at the pancreatic jejunum anastomosis. An anterior abdominal drain enters this collection. SPLEEN: No significant abnormality noted.PANCREAS:Postsurgical changes of Whipple procedure.Prominent pancreatic duct with short segment of stricturing immediately proximal to the anastomosisDiffuse restriction and low T1 signal throughout the pancreas suggests some degree of active inflammation/pancreatitis, however enhancement is normal. Normal response to secretin administration.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: Bilateral simple appearing renal cysts. Additional renal T2 hyperintensities are too small to characterize but likely represent cysts.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.
1.Suggestion of anastomotic leak with decreased size of subhepatic collection.2.Prominent pancreatic duct with short segment of stricturing immediately proximal to the anastomosis.3.Diffuse restriction and low T1 signal throughout the pancreas suggests some degree of active inflammation/pancreatitis.