64-year-old male patient with cholestasis, liver biopsy with biliary perforation with suggestion of extrahepatic biliary obstruction. Patient is status post OLT. Limited study due to the lack of intravenous contrast.ABDOMEN:LIVER, BILIARY TRACT: Subcentimeter T2 hyperintense lesions in the right lobe of the liver likely represent cysts. Mild intrahepatic biliary ductal dilatation. At the expected level of the anastomosis, there appears to be a focal stricture (series 5 image 82). There also may be narrowing of the common bile duct at the level of the ampulla.The hepatic vasculature appears patent.SPLEEN: No significant abnormality noted.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: No significant abnormality 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 intrahepatic biliary ductal dilatation with concern for a stricture at the expected level of the anastomosis with question of narrowing at the ampulla. Recommend an ERCP for further evaluation.