Abdominal pain. Evaluate for retained stone in the pancreatic duct. History of internal pseudocyst drainage. ABDOMEN:LIVER, BILIARY TRACT: The liver is normal in morphology, signal intensity and size. No focal lesion. Status post cholecystectomy. No intra or extrahepatic biliary ductal dilatation. No filling defect in the common bile duct to suggest a retained stone. There is minimal non-loculated fluid in the gallbladder fossa, improved from the prior.SPLEEN: No significant abnormality noted. Minimal perisplenic and perihepatic fluid.PANCREAS: Susceptibility artifact from a cystogastrostomy catheter in the main pancreatic duct at the level of the distal pancreatic body is noted within a tiny intraparenchymal fluid collection (series 901/22). Distal to the catheter there is moderate pancreatic ductal dilatation. There is no definite communication with the more down-stream pancreatic duct, suggestive of a stricture without a discrete filling defect or mass lesion. Evaluation is limited by lack of intravenous contrast. The distal pancreatic body and tail demonstrates mild increase in restricted diffusion, decreased intrinsic T1-weighted signal and mild T2-weighted hyperintensity compatible with mild inflammation. There is an adequate pancreatic excretion response from the downstream pancreatic duct to secretin administration.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: Moderate bilateral pleural effusions with adjacent compressive atelectasis.
1. Limited non-enhanced study demonstrates a suspected stricture at the level of the cystogastrostomy catheter with upstream pancreatic ductal dilatation and mild pancreatic parenchymal inflammation. There is no definite communication with the more down-stream pancreatic duct which is normal in caliber. No filling defect or discrete mass lesion, within the limitation of an unenhanced study. 2. Tiny residual fluid collection at the level of the distal pancreatic body. 