History of hepatic metastases with abdominal pain and elevated liver enzymes, evaluate for biliary obstruction. ABDOMEN:LUNG BASES: Small left pleural effusion. Right breast prosthesis partially visualized.LIVER, BILIARY TRACT: The liver is enlarged. The liver parenchyma is replaced with innumerable heterogeneous enhancing masses encompassing greater than 90% of the liver volume consistent with diffuse metastatic disease. The main portal vein is patent. There is attenuation of the right portal vein without obvious thrombus. The hepatic veins are poorly visualized.There is mild segmental intrahepatic biliary duct dilation particularly in the left lobe (series 8, image 152) likely from the parenchymal metastases. The extrahepatic bile ducts are normal in caliber.SPLEEN: No significant abnormality noted.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: Prominent aortocaval lymph nodes are present.BOWEL, MESENTERY: There is mild nodular thickening of the peritoneum adjacent to the inferior aspect of the spleen and elsewhere with associated restricted diffusion suspicious for peritoneal carcinomatosis.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: Moderate volume ascites.
1.Diffuse metastatic disease throughout the liver.2.Mild segmental intrahepatic biliary ductal dilatation likely related to parenchymal metastases. No extrahepatic biliary ductal dilatation.3.Findings suspicious for peritoneal carcinomatosis. Moderate volume ascites.