Biliary dilation and chronic pancreatitis. Portal vein thrombus. Hepatitis C and alcoholic liver disease. Per medical record, patient has history of chronic pancreatitis and dilated pancreatic and CBD ducts in 2004, s/p pancreaticojejunostomy, choledochoduodenostomy, cholecystectomy, splenectomy at Rush for obstructive jaundice. Since then, he has been found to have biliary dilatation on his MRI MRCP in July 2014. ABDOMEN:LIVER, BILIARY TRACT: Cavernous transformation of the portal vein, similar to that seen on the CT on 11/3/2014, reflecting chronic thrombosis. The recanalized right portal vein is seen, though narrow. The left portal vein is not well seen. There is diffuse nodular enhancement of the liver on arterial phase, which becomes homogeneous on venous phase, without washout to raise suspicious for focal lesions. No specific stigmata of cirrhosis. There is moderate diffuse biliary dilation. The hepatic duct measures up to 8 mm wide, with smooth narrowing of the common bile duct at the choledochoduodenostomy, which remains patent and similar to the CT on 11/3/14. No associated mass is seen.SPLEEN: Surgically absent.PANCREAS: Post surgical changes at the pancreatic head and pancreaticojejunostomy, without complication evident. The remaining pancreas is atrophic with heterogenous parenchymal T1 signal and beading irregularity of the pancreatic duct, compatible with the known history of chronic pancreatitis. No focal mass is seen.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: Multiple bilateral renal cysts. Otherwise, no significant abnormality noted.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Evidence of pancreaticojejunostomy and choledochoduodenostomy, without acute abnormality noted.BONES, SOFT TISSUES: No significant abnormality noted.
1. Stable post-surgical biliary changes and moderate biliary dilation. No specific evidence of complication. 2. Chronic portal vein thrombosis with cavernous transformation, similar to 2014. No specific evidence of cirrhosis.