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Please see report fromAdvanced radiology EXAM: CT ABDOMEN AND PELVIS WITH CONTRASTHISTORY: Gastro-esophageal reflux disease without esophagitis. Atopic dermatitis, unspecified. Lower abdominal pain, unspecified. Patient states has mid abdominal pain with nausea and clay colored stools since October 29.2025.TECHNIQUE: Transverse helical scan obtained from above the diaphragm, including the lung bases, to below the symphysis pubis with administration of intravenous contrast material. Multiplanar 2D reformations obtained from transverse images. One or more of the following dose reduction techniques were used: automated exposure control, adjustment of the mA and/or kV according to patient size, use of iterative reconstruction technique. IV Contrast: 75 ml of Omnipaque 350 was injected.COMPARISON: 5/25/2021FINDINGS:Lower chest: There are multiple new nodules in the lower lungs. 1.3 cm nodule in the left lung base is cavitated.Hepatobiliary: There are multiple new lobulated low-attenuation liver masses. The largest mass is in the left lobe measuring 5.7 x 6.9 cm. There is a 1.5 cm gallstone.Spleen: Unremarkable.Adrenal glands: No significant interval change of mild nodular thickening in the left adrenal gland.Pancreas: Atrophy. Diffuse dilatation of the pancreatic duct. There is a 3.1 x 2.8 cm lobulated mass in the pancreatic pancreatic head and uncinate process. It is highly suspicious for pancreatic carcinoma. The proximal superior mesenteric artery is markedly narrowed secondary to tumor encasement. There is a 1.9 x 1.4 cm lymph nodes lateral to the pancreatic head. 1.8 x 1.3 cm mass is noted above the pancreatic neck on image 49 series 2.Urinary tract: Right kidney: No significant renal lesion. No hydronephrosis or hydroureter.Left kidney: No significant renal lesion. No hydronephrosis or hydroureter.Urinary bladder: The urinary bladder is unremarkable.Uterus and adnexa: Status post hysterectomy.Gastrointestinal tract: Bowel is normal caliber. No focal inflammatory lesion to suggest acute process.Abdomen and pelvis vascular: No abdominal aortic aneurysm.Other abdomen and pelvis structures: Trace pelvic fluid. No free air.Musculoskeletal: No acute findings.IMPRESSION:Pulmonary nodules, liver masses, pancreatic mass or pancreatic nodule and lymph node. The findings are highly suspicious for metastatic pancreatic carcinoma.Cholelithiasis.A stat report was made to the referring physician\'s office at the time of interpretation. As no recent serum creatinine measurement is available at the time of this scheduled contrast-enhanced examination, a serum creatinine test was ordered and performed. The measured iSTAT result is:Creatinine: 1.18 mg/dL (Reference Range: 0.6-1.3 mg/dL)The estimated glomerular filtration rate was calculated and measures: 46 mL/min/1.7 square meters, correlating with Stage 3 Kidney Disease.

November 28, 2025 - 08:01 pm