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CT Abd IPMN

Findings: The liver demonstrates normal attenuation. The gallbladder demonstrates multiple well-circumscribed low density lesions most likely representing cholesterol stones. There is no gallbladder wall thickening. Common bile duct is dilated measuring 10 mm. Pancreas is atrophic. Main pancreatic duct in the body of pancreas is dilated measuring 4-5 mm (Se:3, Im:23). A focal area of hypodensity in the tail of the pancreas may represent a sidebranch tumor. Several calcifications are noted within the spleen consistent with old granulomatous disease. Hypoattenuating lesion is noted within the left adrenal gland, HU: 80, measuring 1.8 x 1.6 cm. Right-sided adrenal gland is unremarkable. The kidneys demonstrate normal cortical enhancement. There is right-sided interpolar calcification measuring 10 mm. Bilateral renal artery atherosclerosis is noted. Enteric contrast extends to the rectum. Proximal jejunum diameter of 3cm is at upper level of normal. There is no evidence of free fluid or free air in the peritoneal cavity. The hollow viscera are without evidence of wall thickening, mass or obstruction. There is no lymphadenopathy. The bladder is normal. Multiple calcifications are noted within the prostate. Severe degenerative changes of thoracolumbar spine are noted. IMPRESSION: 1. Common bile duct and main pancreatic duct dilatation. More focal dilatation in the pancreatic tail may represent a sidebranch tumor such as IPMN. (13146953) 2. Gallbladder findings as above are consistent with chronic cholecystitis; adenomyomatosis could have a similar appearance. 3. Nonspecific left adrenal lesion; correlate with laboratory function. If no abnormalities, consider followup in one year to assess any growth. 4. Right-sided nephrolithiasis. 5. Diffuse generalized atherosclerosis. 6. Severe degenerative changes as above.