Follow-up examination 3 months later to monitor treatment response, and to exclude an underlying mass.
There has been interval reduction in size of the pancreatic head with reduction in the degree of peripancreatic inflammatory change. The maximal diameter of the pancreatic head currently measures 3.5 x 3.0 cm compared with 4.7 x 4.0 cm previously.
There is hypodense material in the pancreaticoduodenal groove and extending into the pancreatic head. There is some infiltration of the fat plane along the anterior surface of the pancreatic head which has reduced in the interim since the prior study.
The previously noted discrete cystic pancreatic head lesion is no longer apparent however the pancreatic parenchyma in the head appears heterogeneous with focal areas of low attenuation. The pancreatic duct remains mildly dilated (4 mm). There is no biliary ductal dilatation. The fat planes are preserved surrounding the celiac, SMA and hepatic arteries. The portal vein splenic vein and SMV the normal. No concerning upper abdominal lymphadenopathy. No focal liver lesions.