63 year old male. History of pseudocyst and pancreatic necrosis status post 1 cystogastrostomy and 2 cystoduodenostomy stent placements. Cystogastrostomy drain has since been removed. ABDOMEN:LIVER, BILIARY TRACT: Cholecystectomy clips. Mild central intrahepatic and extrahepatic biliary ductal dilatation with smooth tapered narrowing in the pancreatic segment, likely due to a benign stricture. No suspicious hepatic mass. Patent hepatic vasculature.SPLEEN: No focal splenic lesion. Chronic thrombosis of the splenic vein with collateral vessels.PANCREAS: Marked atrophy and associated decreased T1 signal intensity of the pancreatic neck, body, and tail with relative sparing of the head, consistent with chronic pancreatitis. The main pancreatic duct is mildly tortuous and has an irregular contour from the neck to tail without significant dilatation, likely from multifocal strictures. Multiple hypoattenuating foci noted on prior CT corresponding to cystic foci scattered throughout the pancreas, greatest in number within the tail where they are clustered, likely represent dilated sidebranch ducts related to chronic pancreatitis.The 1.5 cm small cystic lesion in the pancreatic head seen on prior CT is favored to represent a dilated sidebranch duct and not a pseudocyst.No appreciable increase in ductal caliber after secretin administration.No pseudocyst or significant fluid collection is identified. Cystoduodenostomy stents are not well visualized due to technique.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.
Findings consistent with chronic pancreatitis with relative sparing of the head. Multiple cystic foci scattered throughout the pancreas, greatest in number in the tail, likely represent dilated sidebranch ducts due to multifocal stricturing of the main pancreatic duct. No pseudocyst or significant fluid collection is identified.