Female 62 years old Reason: r/o obstruction History: conjugated hyperbilirubinemia ABDOMEN:LIVER, BILIARY TRACT: Liver is normal in morphology. There are 2 cystic-appearing lesions involving the left hepatic lobe. The more lateral lesion has layering hemorrhage or debris within it and measures 3.9 x 3.1 cm. No definite solid hepatic lesions.There are few scattered other smaller lesions are too small to characterize.Hepatic and portal veins are patent. Gallbladder is distended with sludge and some debris. There is no intrahepatic or extrahepatic biliary ductal dilatation.SPLEEN: No significant abnormality noted.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: Small focal nonenhancing areas in the kidneys bilaterally which are wedge-shaped. Differential considerations include focal pyelonephritis vs. infarctions. No hydronephrosis.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Scattered mesenteric ascites.BONES, SOFT TISSUES: Body wall anasarca.OTHER: Probable uterine fibroids.There is bibasal atelectasis and pleural effusions, right greater than left.INDEX LESION MEASUREMENTS (Current exam date/time: 2/12/2016 21:00:00)LEFT HEPATIC LOBE LESION: 3.9 x 3.1 cm (Image 85, Series 13).
1.No evidence of biliary ductal dilatation.2.Mild gallbladder distention with sludge.3.Lesion in the left hepatic lobe with layering debris or hemorrhage. Differential considerations include complex cyst, biliary cystadenoma, biliary hamartoma.4.Focal areas of nonenhancement in the kidneys differential considerations include focal pyelonephritis or infarctions. No hydronephrosis.