Assess hepatic vessel patency. Status post orthotopic liver transplant in 1990. Recurrent cirrhosis. ABDOMEN:LIVER, BILIARY TRACT: Cirrhotic liver morphology with regions of confluent fibrosis with no suspicious focal lesion. Two small hepatic cysts.Dilated patent portal vein. TIPS catheter in expected position was better opacified on the prior study with poor opacification near its middle hepatic vein landing site on today's examination.Diffuse iron deposition.SPLEEN: Splenomegaly measuring 17 cm in length without a focal lesion. Perisplenic collateral vessels.PANCREAS: 9 mm pancreatic head cystic lesion appears to communicate with the normal caliber main pancreatic duct, compatible with a side branch IPMN without suspicious imaging features, unchanged.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.
1.The TIPS catheter is poorly opacified at the level of the middle hepatic vein landing site, especially when compared to the prior. Consider ultrasound evaluation if there is concern for TIPS thrombosis/stenosis. No ascites.2.Cirrhosis and stigmata of portal hypertension (splenomegaly and perisplenic collateral vessel formation). No suspicious liver lesion.3.Stable pancreatic head subcentimeter sidebranch IPMN without suspicious imaging features.