Female 58 years old Reason: Gall stones, CBD stones, Sphincter of Oddi dysfunction. PERFORM with SECRETIN STIMULATION History: pain with eating ABDOMEN:LIVER, BILIARY TRACT: Subcentimeter cyst in the right hepatic dome. An enhancing focus with no washout in the right hepatic dome may represent a venovenous shunt. No suspicious liver lesion. There is diffuse loss of signal within the liver parenchyma out of phase imaging indicating hepatic steatosis. No intra or extrahepatic biliary ductal dilatation.SPLEEN: No significant abnormality noted.PANCREAS: The pancreas enhances homogeneously. The pancreatic duct is diffusely dilated up to 5 mm to the level of the ampulla. There is no significant change in post secretin images.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: Bilateral simple renal cysts and a minimally complex right renal cyst.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Colonic diverticulosis.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.
1.Diffuse pancreatic ductal dilatation to the level of the ampulla with no change on post secretin images. No pancreatic mass is seen. Dilatation may be due to a stricture at the level of the ampulla or sphincter of Oddi dysfunction although this is less likely given the normal caliber common duct. A main duct IPMN is not excluded.2.Hepatic steatosis.