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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.

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.