62-year-old man with history of pancreatitis and pancreatic fluid collection. Please note this examination is slightly limited by patient motion.ABDOMEN:LIVER, BILIARY TRACT: There is a 7 mm hepatic cyst (series 3, image 11). The liver is otherwise normal in signal and morphology. There is mild intrahepatic biliary ductal irregularity. No dominant stricture or mass. The portal vein is not visualized and there were numerous collateral vessels in the hepatic hilum.SPLEEN: The spleen is normal.PANCREAS: Within the body/tail of the pancreas (series 3, image 17) there is a 15 x 9 mm T2 hyperintense, nonenhancing focus which appears to communicate with the pancreatic duct. No debris is seen within this lesion.Additionally, there is a 6 x 6 mm area of intermediate T2 signal and low T1 signal in the mid pancreatic tail (series 12, image 243) without enhancement which is in the same location as, but smaller than, a pseudocyst seen on the CT from 8/10/2015. There is slightly increased T2 signal within the parenchyma of the pancreatic tail.Adjacent to this tail lesion, there is a smooth stricture of the pancreatic duct (series 7, image 5). Secretin augmentation demonstrates a slightly blunted exocrine response, however the duodenal C-loop fills with fluid.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: Multiple left renal cysts are noted. The kidneys are otherwise normal and enhance symmetrically.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: There is a moderate left pleural effusion with adjacent atelectasis.
1.Interval decrease in size of pancreatic tail pseudocyst from 8/10/2015 with residual adjacent pancreatic duct stricture.2.Mild inflammation in the pancreatic tail.3.Lesion in the pancreatic head/neck which likely represents a side branch IPMN and less likely a small pseudocyst as was present on the CT dated 7/1/2015 prior to the pancreatitis4.Cavernous transformation of the portal vein.5.Left pleural effusion.