Thank you for your comment. The concern is actually not the IPMN's as far as I know-they are >5mm. The concern is for a mass or stricture likely in the area where the head/duct meets the small intestine from what they have told me (I spoke with them after I posted this). The reason they are thinking this is because of increased duct dilatation in the pancreas, liver CBD, and intrahepatic ducts. So they think it is a pressure issue downstream from the liver. My confusion is why last year's EUS/ERCP didn't show any obstruction or this new ERCP. Is it possible that without any suspicion of a stricture, that area was not looked at? Or maybe that area is hard to image and something like a stone could hide there.