2-year-old male with pancreatitis. Evaluate for structural abnormalities.EXAMINATION: MRI MRCP without and with intravenous contrast 12/16/2016 10:00 The pancreatic head, body and majority of the tail is normal demonstrating normal homogeneous enhancement. The distal aspect of the pancreatic tail is indistinct with adjacent intermediate signal intensity, stranding and free fluid. A complex rim-enhancing structure is present in the region of the distal pancreatic tail measuring 3 cm x 2 cm (series 1601, image 38). There are enhancing septations within the fluid collection in the left upper quadrant. There are adjacent smaller loculated fluid collections in the left lower quadrant (for example series 1601, image 29). No pancreatic ductal dilatation. Moderate amount of fluid is present in the upper abdomen. Stranding of the perinephric fat on the left is noted. No intra or extrahepatic biliary ductal dilatation. The liver, spleen and gallbladder are normal.The kidneys demonstrate normal enhancement with symmetric excretion of contrast. The bladder is moderately distended.The adrenal glands are normal.Bilateral small pleural effusions.
1. Focal pancreatitis of the pancreatic tail with adjacent peripancreatic fluid collection demonstrating complex features likely representing a peripancreatic fluid collection transitioning into a pseudocyst. There are adjacent smaller loculated fluid collections.2. No biliary or pancreatic ductal dilatation.3. Moderate amount of fluid in the upper abdomen with multiple septations in the left upper quadrant. This extends inferiorly and posteriorly involve the left perinephric space.4. Bilateral small pleural effusions.