Technique:

Axial images acquired on a multislice scanner, with IV contrast administration.

Clinical history:

[ __ ]

Comparison:

CT abdomen and pelvis dated [ __ ]/[ __ ]/[ __ ]

Findings:

The liver is normal in size and contour with homogeneous attenuation.
Hepatic and portal veins are patent.
No biliary ductal dilatation.

Solid lesion with a hypoattenuating center suggestive of liquefactive necrosis in the pancreatic head, measuring cm along its greatest axial diameter, with mild peripancreatic fat stranding. Findings raise the possibility of a primary neoplasm or, alternatively, an inflammatory process (focal pancreatitis). Clinical correlation is recommended.

Spleen and adrenal glands are unremarkable.
Kidneys are normal in size. No calculi or collecting system dilatation.

The aorta is normal in course and caliber.

The urinary bladder is distended and unremarkable.
No abdominal lymphadenopathy or free fluid.

Impression:

1. Solid hypoattenuating lesion in the pancreatic head with adjacent peripancreatic fat stranding. Primary neoplasm versus focal pancreatitis. Recommend MRI/MRCP or endoscopic ultrasound for further characterization.
2. Diffusely distended small bowel loops without an identifiable obstructing lesion, which may reflect enteritis. Clinical correlation is recommended.
3. Atherosclerotic calcification of the aorta and iliac arteries. No significant interval change from the prior study.