History of orthotopic liver transplant in 2013 for hepatocellular carcinoma. Evaluate for lesions, assess vessel patency, assess biliary system. ABDOMEN:LIVER, BILIARY TRACT: Stable postoperative changes from orthotopic liver transplant. There are expected foci of susceptibility related to surgical clips and changes in the porta hepatis and anterior abdominal wall. There are additional small foci of susceptibility within the biliary tree compatible with pneumobilia. There is stable trace intrahepatic biliary ductal dilatation.The main portal vein, left portal vein, and majority of the right portal vein are patent. The segment 8 branch of the portal vein is again poorly seen compatible with thrombosis. There is associated wedge-shaped early arterial enhancement throughout this segment compatible with vascular redistribution secondary to the thrombosis. The hepatic veins are widely patent. The hepatic artery anastomosis is obscured by susceptibility artifact, but the arteries are otherwise patent.The liver has normal signal and morphology. No focal suspicious enhancing lesion. SPLEEN: Borderline splenomegaly. No focal lesion.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: Note is made of multiple esophageal varices appearing similar to prior.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.
1.Stable appearance of the liver status post transplant. There are persistent findings relating to thrombosis of the segment 8 branch of the portal vein. The remaining vasculature remains widely patent. Stable minimal intrahepatic biliary ductal dilatation. No suspicious enhancing lesions.2.Persistent findings of portal hypertension including splenomegaly and esophageal varice formation.