Reason: 57 y.o. with autoimmune enterocolitis on cyclosporine, with persistently elevated bilirubin. h/o gallstones. Please eval for obstruction/choleystatis. History: persistently trending up bilirubin, jaundice. ABDOMEN:LIVER, BILIARY TRACT: No focal hepatic lesion. Low insertion of the cystic duct is noted. There is no intra or extrahepatic biliary ductal dilatation. The common duct is well seen to the level of ampulla. No evidence of choledocholithiasis.There is biliary sludge within the gallbladder with layering stones.SPLEEN: No significant abnormality noted.PANCREAS: Age-related pancreatic atrophy. Pancreatic duct is normal in caliber.ADRENAL GLANDS: Right adrenal gland nodule measures 1.7 cm. It loses signal on out of phase imaging and is compatible with an adenoma.KIDNEYS, URETERS: Kidneys are mildly atrophic bilaterally. No suspicious focal renal lesion.RETROPERITONEUM, LYMPH NODES: No significant retroperitoneal lymphadenopathy.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.
No evidence of choledocholithiasis. There is layering biliary sludge and stones within the gallbladder. No intra or extrahepatic ductal dilatation.1.7 cm right adrenal adenomaI personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report.