Abdominal pain. Evaluate for cholecystitis. ABDOMEN:LIVER, BILIARY TRACT: Giant hemangioma involving the posterior segment of the right hepatic lobe measuring 10.5 x 9.8 cm. Cholelithiasis with a gallstone at the gallbladder neck. Other scattered subcentimeter T2 hyperintesities, likely small cysts, but too small to characterize.The gallbladder is distended, hyperemic and with pericholecystic fluid superiorly compatible with acute cholecystitis. There is mild mass effect on the common hepatic duct resulting in mild intrahepatic ductal dilatation. The common hepatic duct is patent on MRCP images.No filling defect in the common bile duct is evident.SPLEEN: No significant abnormality noted.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: Symmetric mild perinephric fluid is likely chronic.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: Mild degenerative endplate changes.OTHER: Mild basilar atelectasis.
1.Large gallstone impacted in the gallbladder neck resulting in acute cholecystitis with gallbladder wall thickening and pericholecystic fluid. Mass effect from the gallstone results in mild common hepatic and intrahepatic bile duct dilatation (Mirizzi syndrome) - the CBD is patent, however.2.Giant cavernous hemangioma involving the posterior right hepatic segment.I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report.