Evaluate for biliary stones, dilatation seen on prior sonography, reportedly status post OLT in 1996 ABDOMEN:LIVER, BILIARY TRACT: Mild hepatomegaly. Left greater than right biliary duct dilatation. Dilatation extends to level of what appears to be proximalmost CBD where there is a focus of signal void suspicious for choledocholithiasis, focus measures up to 10 mm in coronal plane (image 20 series 701). Please note that a focal stricture at this level (at presumed site of postsurgical anastomosis) cannot be excluded. Possible separate left-sided biliary system that appears to end blindly on image 23 series 601, correlate with patient's operative report. Possible additional minimal ductal debris/stones in left liver. There is a fairly simple appearing fluid collection in the left upper quadrant that extends to level of greater curvature of stomach, collection measures 10 x 3 cm on image 19 series 501 and was not present on prior 2012 CT study, no corresponding T1 hyperintensity seen. Hepatic cyst formation.SPLEEN: Splenule formation. Relatively decreased T2 signal in spleen when compared to liver and suggestion of mildly decreased signal in liver parenchyma on in phase imaging compared to opposed phase imaging, may be seen in setting of iron deposition disease.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: Small renal cyst formation.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: Mild anasarca. Possible subcentimeter thoracic vertebral body hemangioma. Ventral abdominal postsurgical sequela.
1. Left greater than right intrahepatic biliary duct dilatation, extending to level of 10 mm focus of signal void suspicious for choledocholithiasis. Please note that a focal stricture at this level, at presumed site of postsurgical anastomosis, cannot be excluded.2. Left upper quadrant fluid collection extending from superior/medialmost aspect of liver inferiorly towards greater curvature of stomach, nonspecific and correlation with patient's procedural history recommended, biliary leak not excluded.3. Equivocal findings for iron deposition disease as above.