60 year-old female. Right upper quadrant pain, transaminitis in patient status post liver wedge resection for pancreatic cancer. Evaluate for biliary obstruction, liver morphology. ABDOMEN:LIVER, BILIARY TRACT: Post-surgical findings of left hepatic lobe wedge resection. 2.7 x 2.2 cm lesion in the residual left hepatic lobe that is intrinsically T1 hyperintense without appreciable enhancement on post-contrast sequences, most likely a hematoma.Mild central intrahepatic and markedly diffuse extrahepatic biliary ductal dilatation measuring up to 2.6 cm with transition point at the pancreatic head mass.Subcentimeter left hepatic lobe cyst. Post-surgical findings of cholecystectomy.SPLEEN: No significant abnormality noted.PANCREAS: Heterogeneously enhancing pancreatic head mass is 5.9 x 4.6 cm (undermeasured on prior CT). Pancreatic duct upstream to this mass is dilated at 5 mm. The mass is again seen to abut the GDA and 180 degrees of the SMV, which is attenuated.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: Mildly enlarged portacaval lymph nodes, similar to prior.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: Mild degenerative changes in the spine. Post surgical changes in the anterior abdominal wall.OTHER: Small amount of pelvic ascites.
1.Intrahepatic and marked extrahepatic ductal dilatation is due to the obstructing pancreatic head mass consistent with known pancreatic carcinoma.2.Previously noted fluid collection in the superior margin of the left hepatic lobe on prior CT is likely a small hematoma.