Strikingly large giant hepatic cavernous hemangioma. This has the potential of distracting from the acute issue, which is acute pancreatitis. The pancreatic ductal dilation, gallstones, and possible small stone in the distal CBD raises the possibility of gallstone pancreatitis, which could be future evaluated with MRCP or ERCP. 

Despite the size of the hemangioma, it is a chronic finding. It is helpful to realize how large these can get, and at this size, it would be appropriate to recommend subspecialty evaluation for follow-up recommendations to ensure no rapid growth or consumption coagulopathy occurs. 

Teaching points¹: 

• "giant" > 5 cm
• usually asymptomatic, may have mass effect
• associations: Klippel-Trenaunay-Weber, Osler-Rendu-Weber, and von Hippel–Lindau
• complications: hemorrhage, consumption coagulopathy (Kasabach-Merritt)