Rising bilirubin. Evaluate for hepatic injury or biliary obstruction. History of Crohn's disease status post ileal resection and stricturoplasty. ABDOMEN: Limited evaluation due to lack of intravenous contrast. LIVER, BILIARY TRACT: TIPS catheter noted. Cirrhotic liver morphology without a discrete lesion on limited non-enhanced study. Small volume perihepatic ascites. Distended gallbladder without gallstones or significant wall thickening..SPLEEN: The spleen measures 12.9 cm in craniocaudal dimension without a focal lesion. Small volume of perisplenic ascites.PANCREAS: The pancreas is normal in morphology and signal intensity without pancreatic ductal dilatation or focal lesion.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: No hydroureteronephrosis or suspicious lesion.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Markedly dilated small bowel loop in the upper abdomen measuring up to 9.6 cm, not significantly changed from small bowel follow-through dated 11/19/2014. No proximal small bowel dilatation.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: Large right and small left pleural effusion with bibasilar consolidation/atelectasis, see same day chest radiograph.
1.Distended gallbladder without cholelithiasis, choledocholithiasis or significant gallbladder wall thickening; may be seen in fasting state. No biliary ductal dilatation.2.Cirrhosis.3.Limited nonenhanced evaluation of the upper abdomen shows no additional significant abnormality. 4.Large right and small left pleural effusion with adjacent consolidation or atelectasis. Small volume ascites.5.Persistently dilated small bowel loop in the midabdomen is similar to prior small-bowel follow-through.