44-year-old male with pancreatitis. Rule out pancreatic duct obstruction. Motion artifact limits evaluation on multiple sequences. Within this limitation, the following observations are made.ABDOMEN:LIVER, BILIARY TRACT: No suspicious hepatic lesions. Distention of the gallbladder and prominence of the central intrahepatic bile ducts and common bile duct without evidence of distal obstructing stone; these findings may be due to fasting state or pancreatitis (see below).SPLEEN: No significant abnormality noted.PANCREAS: Mild atrophy of the pancreas diffusely with loss of normal high T1 signal. Main pancreatic ductal dilation measuring up to 11 mm with multiple side branches visualized. Low T1 and T2 signal material measuring about 7 mm without enhancement is seen within the main pancreatic duct in the head, most compatible with impacted debris and/or stone (series 4/15). Mild-to-moderate peripancreatic edema predominantly around the head with a small amount of free fluid is also seen extending down the right paracolic gutter. Overall, the findings are most compatible with acute on chronic pancreatitis due to obstructing pancreatic duct stone. There is increased wall thickening with enhancement of the adjacent descending duodenum, most likely reactive. 2.1 x 1.1 cm loculated fluid collection posterior to the descending duodenum (series 501/12), most likely a pancreatic pseudocyst. A subcentimeter T2 hyperintense cystic lesion within the uncinate is also likely due to a small pseudocyst. ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: Prominent peripancreatic lymph nodes are most likely reactive.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: Trace left pleural effusion partially visualized.
1. Findings most compatible with acute on chronic pancreatitis due to obstructing pancreatic duct stone, as detailed above.2. Small probable pseudocyst posterior to the descending duodenum with additional smaller probable pseudocyst in the uncinate process.3. Findings suggestive of reactive duodenitis.