History of CFTR mutation with hypertriglyceridemia and severe pancreatitis now with worsening pain. Evaluate for pancreatic duct stricture and new fluid collection. ABDOMEN:LIVER, BILIARY TRACT: The liver is normal in morphology and size measuring 19.4 cm in craniocaudal dimension. Loss of signal intensity on out of phase imaging compatible with diffuse fatty infiltration. No suspicious liver lesion. No significant intra or extrahepatic biliary ductal dilatation with the common bile duct measuring 7 mm. The patient is status post cholecystectomy.SPLEEN: Status post splenectomy.PANCREAS: Status post distal pancreatectomy. The pancreas is mildly atrophic. It demonstrates decreased intrinsic T1 weighted signal intensity and overall postcontrast enhancement. No evidence of parenchymal necrosis or hemorrhage. No significant parenchymal edema or peripancreatic fluid/fat stranding.Along the anterior pararenal fashion dorsal to the pancreatic tail is a 3.3 x 2.1 cm fluid collection along the lesser curvature of the stomach demonstrating thin wall enhancement compatible with a pseudocyst given the patient's history. There is minimal fluid surrounding the duodenal sweepNo evidence of arterial pseudoaneurysm or venous thrombosis.There is mild irregular narrowing, dilatation and mural contour of the main pancreatic duct (series 3 image 85 and 96) which is improved from the prior and is patent throughout, compatible with stigmata of chronic/prior pancreatitis. ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.
Mild irregular dilatation, narrowing and mural contour of the main pancreatic duct, improved in caliber from the prior, compatible with stigmata of chronic/prior pancreatitis. 3.3 cm air and fluid collection anterior to the left adrenal gland abutting the lesser curvature of the stomach. This likely represents a pseudocyst when comparing to prior studies and much less likely a gastric diverticulum. It is mildly increased from the prior study.Fatty infiltration of liver.