Reason: biliary duct dilation/obstruction History: Abdominal painAdditional history per electronic medical record:History of pancreatitis with elevated lipase. Examination mildly limited by patient motion.ABDOMEN:LIVER, BILIARY TRACT: The liver demonstrates normal background parenchymal signal intensity and enhancement. There is no significant loss of signal on out of phase images to suggest fatty infiltration. No suspicious focal hepatic lesions are identified.The hepatic vasculature appears patent.The gallbladder is contracted and contains gallstones. No significant pericholecystic inflammatory changes are identified. No intra or extrahepatic biliary ductal dilatation is identified. The common bile duct measures up to 5 mm. No evidence of choledocholithiasis.SPLEEN: No significant abnormality noted.PANCREAS: The pancreas demonstrates normal background T1 parenchymal signal intensity and enhancement. There is mildly increased T2 and DWI signal within the pancreatic head, uncinate process, and body suggestive of acute pancreatitis. There is also diffuse loss of the normal pancreatic lobulations with suggestion of a hypointense pancreatic rim. No focal pancreatic lesions are identified. The pancreatic duct is not well-visualized but is nondilated. No significant peripancreatic inflammatory changes are identified.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: Trace pelvic free fluid which may be physiologic.
1.Cholelithiasis without evidence of acute cholecystitis, choledocholithiasis, or biliary ductal dilatation.2.Findings suggestive with acute pancreatitis without evidence of complication. Autoimmune pancreatitis is a differential consideration, consider correlation with serum IgG levels.3.Pancreatic duct is poorly visualized but nondilated.