58-year-old male with history of hepatic encephalopathy and portosystemic shunting. ABDOMEN:LUNG BASES: Small right pleural effusion.LIVER, BILIARY TRACT: Status post OLT. Patent portal vein. No significant intra or extra hepatic biliary ductal dilatation.SPLEEN: Portosystemic shunting with abundant dilated collaterals near the splenic hilum.PANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: Bilateral renal cysts unchanged.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality notedOTHER: There are tortuous collateral vessels in the right retroperitoneum arising from the SMV which have increased in size when compared to the prior MRI from 2014 now measuring up to 25 mm, previously 19mm. Segment of abnormal straightening near the confluence with the IVC likely represents area of stent placement and intervention. Moderate volume ascites.PELVIS:PROSTATE, SEMINAL VESICLES: No significant abnormality notedBLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: Small bowel is dilated with some bowel wall thickening.BONES, SOFT TISSUES: No significant abnormality notedOTHER: There are tortuous collateral vessels in the right retroperitoneum arising from the SMV which have increased in size when compared to the prior MRI from 2014 now measuring up to 25 mm, previously 19mm. Segment of abnormal straightening near the confluence with the IVC likely represents area of stent placement and intervention. Moderate volume ascites.
Enlargement of prominent spontaneous right retroperitoneal portosystemic shunt. Moderate ascites. Patent portal vein. Small right pleural effusion.