Male 57 years old Reason: Liver protocol. Abdominal pain in patient with physical and lab values suggestive of pancreatitis. Alk phosp elevated (bili okay) evaluate for stones vs infiltrative liver process History: Liver protocol. Abdominal pain in patient with physical and lab values suggestive of pancreatitis. Alk phosp elevated (bili okay) evaluate for stones vs infiltrative liver process ABDOMEN:LIVER, BILIARY TRACT: Liver is normal in morphology. No suspicious hepatic lesions. Mild fatty infiltration of the liver. The hepatic and portal veins are patent. No intrahepatic biliary ductal dilatation. Common bile duct is normal in caliber.There is some sludge within the gallbladder and small calculi are not excluded.SPLEEN: No significant abnormality noted.PANCREAS: The pancreas is low in T1 signal compatible with chronic pancreatitis. There is dilatation of the pancreatic duct up to 1 cm through the neck, body and tail. There are dilated side branches. The pancreatic tail is bifid. In the mid pancreatic body is a focal narrowing with a small filling defect most likely due to a stone measuring 7 mm.There is a possible small stone near the ampulla.There is mild edematous changes involving the pancreatic head and pancreaticoduodenal grooveNo pseudocyst formation.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: There is extensive inflammation surrounding the second portion of the duodenum with a thickened wall and edema that extends to the gallbladder fossa.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.
1.Mild acute on chronic pancreatitis predominantly of the pancreatic head. No pseudocyst formation or evidence of necrosis.2.Pancreatic duct stone measuring 7 mm.3.Edema of the second portion of the duodenum possibly due to adjacent pancreatitis or duodenitis.