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CT Abd CF

Technique: Helical CT of the abdomen/pelvis after administration of IV and oral contrast. Standard 5 mm axial images were obtained with coronal and sagittal reformations. Renal delay images were also obtained. Findings: There is lobar airspace disease with marked bronchiectasis of the right middle lobe. There is also bilateral diffuse patchy airspace disease more prominent on the right, not significantly changed since the most recent CT chest. There is no mass, or pleural effusion. Limited views of the heart are unremarkable. There is significant fatty replacement of the pancreas. There is a round soft tissue density anterior to the SMA and a second one more medial just anterior to the portal vein in the area of the pancreatic head. This likely represents remnant nonfatty infiltrated pancreatic tissue. Otherwise, the liver, spleen, adrenals, and kidneys demonstrate normal morphology and enhancement without mass lesions. Enteric contrast extends to the sigmoid colon. The hollow viscera are unremarkable. There is a minimal amount of inferior right pericolic gutter free fluid, as well as posterior pelvic free fluid. These findings are likely secondary to a chronic inflammatory process. There is no evidence of an acute abdominal process. There is a PEG tube in place in the ventral abdomen, communicating with the gastric antrum. The bladder is normal. The remainder of the soft tissues and osseous structures are unremarkable. IMPRESSION: 1. Diffuse fatty replacement of the pancreas. Small foci of remnant pancreatic tissue are identified, which is the most likely explanation for the prior ultrasound findings. 2. Unchanged right middle lobe bronchiectasis, mucus plugging and patchy diffuse bilateral airspace disease, consistent with history of cystic fibrosis. 3. Small amount of free pelvic and right pericolic gutter fluid, consistent with a chronic inflammatory process.