Recurrent cholangitis. ABDOMEN:LIVER, BILIARY TRACT: Cirrhotic liver morphology, with geographic areas of T2 hypointensity and heterogeneous enhancement. The mildly increased periportal signal intensity representing periportal edema versus inflammation is similar to prior studies. Small amount pericholecystic fluid likely due to cirrhosis, without specific features otherwise of cholecystitis.Multifocal intra-and extrahepatic biliary duct strictures are again seen and consistent with primary sclerosing cholangitis. The short segment stenosis just distal to the confluence of the right and left intrahepatic ducts is not significantly changed. The right and left intrahepatic ducts are again poorly visualized proximal to Klatskin's point, similar to prior exam. The common bile duct remains attenuated throughout its course with a short focal stenosis at the ampulla, similar to prior. No definite mass is identified. Overall the appearance is not significant changed compared to prior study. SPLEEN: Splenomegaly.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: Nonspecific periportal lymphadenopathy, which can be seen in the setting of primary sclerosing cholangitis.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality noted.
1. Multifocal intra-and extrahepatic biliary duct strictures consistent with primary sclerosing cholangitis, without significant interval change or focal mass evident.2. No acute abnormality identified. 