27-year-old male with history of primary sclerosing cholangitis, now with elevated total bilirubin, jaundice, pruritus. Evaluate for a dominant stricture. ABDOMEN:LIVER, BILIARY TRACT: Common bile duct is dilated to 1 cm, proximal to an approximately 2 cm segment of narrowing and irregularity of the distal common bile duct, unchanged compared to the previous examination. There are multiple regions of narrowing and dilatation involving the intrahepatic bile ducts giving beaded appearance, stable. Persistent narrowing of the right common bile duct at the confluence.SPLEEN: Multiple stable splenic cysts. Again noted is a large T2 hyperintense complex cystic lesion in the anterior spleen with multiple enhancing septations measuring approximately 2.7 x 2.1 cm (series 401, image 36) not significantly changed.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: Ahuastration of the colon again with colon measuring up to 6 cm. BONES, SOFT TISSUES: Fluid attenuating focus in the epidural space in the upper thoracic spine partially imaged.OTHER: No significant abnormality noted.
1.No significant change in the intra and extrahepatic biliary stricturing consistent with history of primary sclerosing cholangitis.2.Multiple stable splenic cysts, including a larger nonspecific complex cyst. 3.Ahaustration of the colon consistent with inflammatory bowel disease with persistent dilatation measuring up to 6 cm. 4.Fluid draining focus in the epidural space and upper thoracic spine is partially imaged. If patient has symptoms further evaluation can be obtained by MRI of the T-Spine