Persistent pancreatic-cutaneous fistula. Evaluate fluid collections. ABDOMEN:LIVER, BILIARY TRACT: Small dependent gallstones within a normally distended gallbladder without evidence of gallbladder inflammation.No suspicious liver lesion. The hepatic vessels are patent. Demonstrated again is significant dilatation of the common bile duct measuring 2.0 cm compared to 1.8 cm previously. It tapers smoothly to the level of the ampulla without a discrete filling defect or mass. There is mild intrahepatic biliary ductal dilatation, appearing similar to the prior study.SPLEEN: Normal splenic size without a focal lesion.PANCREAS: Decreased intrinsic T1 weighted signal intensity of the pancreas. Diffuse irregular beaded dilatation of the pancreatic duct with mild narrowing at the pancreatic body. These findings are compatible with chronic pancreatitis. Demonstrated again is a drain extending from the stomach into the main pancreatic duct.No measurable peripancreatic fluid collection. There is soft tissue infiltration anterior to the pancreatic head extending to the adjacent segment 2 of the liver and anterior abdominal wall which may be the source of the patient's reported persistent pancreatico-cutaneous fistula which is not discretely demonstrated on this study. There are several susceptibility artifacts in this region also limiting evaluation.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: Tortuous abdominal aorta with infrarenal aneurysmal dilatation measuring up to 2.5 cm in AP dimension with atherosclerotic disease distally.BOWEL, MESENTERY: No evidence of obstruction. Postsurgical changes from gastric bypass with gastrojejunostomy.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.
Soft tissue infiltration anterior to the pancreatic head extending to the adjacent segment 2 of the liver and anterior abdominal wall which may be the source of the patient's reported persistent pancreatico-cutaneous fistula which is not discretely demonstrated on this study. Susceptibility artifact in this region also limits evaluation. No drainable fluid collection.Persistent significant main biliary ductal dilatation smoothly to the level of the ampulla without a filling defect or mass lesion.Stigmata of chronic pancreatitis with gastropancreatic stent in place. No specific findings of acute pancreatitis.