59 year old female patient with persistent jaundice two weeks after ERCP for choledocholithiasis. Evaluate for etiology of hyperbilirubinemia, extrahepatic vs intrahepatic. ABDOMEN:LIVER, BILIARY TRACT: Cholelithiasis without evidence of acute cholecystitis. There is very mild intrahepatic biliary ductal dilatation, which is best seen on the portal venous phase. No extrahepatic biliary ductal dilatation. No foci of signal void are seen within the common bile duct to suggest choledocholithiasis. No suspicious hepatic lesion is identified. The hepatic vasculature is patent. SPLEEN: No significant abnormality noted.PANCREAS: No evidence of acute pancreatitis. ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: There is a T2 hyperintense exophytic lesion measuring 2.8 x 3.2 cm within the midpole of the left kidney with probable internal septations and without appreciable enhancement (image 38, series 6). An additional subcentimeter T2 hyperintense lesion in left lower pole likely represents a cyst. RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.
1.Very mild intrahepatic biliary ductal dilatation without other acute abnormality to account for the patient's symptoms.2.Cholelithiasis without evidence of cholecystitis.3.Left renal cystic lesion with internal septations; this can be followed on ultrasound in 6-8 months. 