56-year-old male with upper abdominal pain. Elevated lipase consistent with pancreatitis. Evaluate for cholelithiasis. LIVER: The liver parenchyma is mildly coarsened. No intrahepatic biliary ductal dilatation is evident. The liver measures 15 cm in craniocaudal dimension. Note is made of a 2.7-cm right hepatic lobe simple-appearing cyst. There is normal hepatopetal portal venous blood flow at 20 cm/sec.BILIARY TRACT: The common bile duct is mildly prominent, measuring 7 mm at the hilum, unchanged. A normally distended gallbladder is noted without gallstones, wall thickening, pericholecystic fluid, or focal tenderness. PANCREAS: The pancreas is obscured by overlying bowel gas shadowing.SPLEEN: The spleen measures 9.9 cm in length without a discrete lesion.RIGHT KIDNEY: The right kidney is malrotated as seen on the prior CT. It measures 11.1 cm in length without hydronephrosis, shadowing calculus or a discrete lesion evident. Color Doppler demonstrates hilar blood flow.OTHER: The left kidney measures 10.9 cm in length without hydronephrosis, shadowing calculus or discrete lesion evident.
1. The pancreas is obscured by overlying bowel gas shadowing. 2. No evidence of cholelithiasis or acute cholecystitis as clinically questioned. 3. Stable prominence of the common bile duct. 4. Mildly coarsened hepatic parenchyma suggesting diffuse fatty infiltration and/or parenchymal dysfunction.