History of sarcoidosis. Evaluate for biliary obstruction or other abnormality. ABDOMEN:LIVER, BILIARY TRACT: The liver is normal in size with a nodular contour compatible with chronic liver disease. Recanalized periumbilical vein.Note is made of bilateral percutaneous biliary drains with mild adjacent signal changes of the parenchyma. There is persistent irregular narrowing and moderate dilatation of the common bile duct and intrahepatic biliary tree. There is mild enhancement of the biliary tree centrally, unchanged and likely related to chronic mild inflammation. No new dominant stricture or discrete mass lesion. No suspicious arterial enhancing lesion.The main portal vein and intrahepatic portal branches are chronically occluded with extensive perigastric peripancreatic, intrapancreatic and splenic collaterals.SPLEEN: The spleen is normal in size morphology and signal intensity.PANCREAS: The main pancreatic duct appears to drain into the minor papilla compatible with pancreas divisum. No main pancreatic ductal dilatation or focal lesion. There are extensive intra and peri-pancreatic collateral vessels. ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: Bilateral cortical scarring is noted. Splenorenal shunt is again noted.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.
Mild morphologic changes of cirrhosis, chronic portal vein occlusion and stable dilatation/stricturing of the common bile duct and intrahepatic biliary tree. No suspicious hepatic lesion.