77 years, Male, Reason: hx of large pseudocyst. CT 1/21/15 with disruption of PD where AXIOS stent placed. Please eval History: na. ABDOMEN:LUNG BASES: Right basilar opacity is unchanged.LIVER, BILIARY TRACT: Left hepatic subcentimeter cyst. Status post cholecystectomy.Common bile duct is mildly dilated to 8 mm with smooth tapering at its distal aspect. There is mild intrahepatic biliary ductal dilatation.SPLEEN: No significant abnormality noted.PANCREAS: There is a peripancreatic collection measuring 1.7 x 1.1 cm which is decreased from 2.6 x 1.3 cm previously. AXIOS stent entering the pancreatic collection produces local artifact in this region of the pancreas. The pancreatic duct within the distal tail appears to communicate with the peripancreatic lesion (16/5 and 2001/48), indicating disruption of the duct. There is a long segment, subjacent to the stent, in which the pancreatic duct is not well visualized. The pancreatic duct within the head and neck appears normal.Diffusion restriction within the pancreatic tail suggests inflammation.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: Multiple subcentimeter T2 hyperintensities likely represent cysts.RETROPERITONEUM, LYMPH NODES: IVC filter. Mild amount of mural thrombus in the aorta.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.
1.Peripancreatic fluid collection is decreased in size from the prior exam. The main pancreatic duct within the tail appears to communicate with this collection, indicating disruption. The pancreatic duct within the body subjacent to the stent is not well visualized, either due to artifact or disruption.2.Diffusion restriction within the tail of the pancreas suggests inflammation and is likely related to recent episode of pancreatitis.3.Right lower lobe pulmonary opacity may represent consolidation, however neoplasm is also considered, particularly given its persistence. Recommend either short term follow-up or PET-CT.