Status post orthotopic liver transplant for PSC. Evaluate for recurrent biliary stricture. ABDOMEN:LIVER, BILIARY TRACT: The liver is normal in morphology, signal intensity and enhancement. Compared to the 9/26/2014 study, there is a focal stricture of the right hepatic duct just proximal to Klatskin's point and worsening right and left intrahepatic biliary ductal dilatation. The common hepatic/bile duct is normal in caliber with focal narrowing distally just proximal to the hepaticojejunostomy. The portal vein is moderately narrowed at its anastomosis approximately 50%, improved from the prior. The hepatic veins are patent. The hepatic artery is suboptimally evaluated at the porta hepatis.No focal hepatic lesion. Cholecystectomy.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: No significant abnormality noted.BOWEL, MESENTERY: Right lower quadrant focal abdominal wall hernia containing small bowel seen on the coronal series 2 image 36 is incompletely evaluated. On coronal series 2 image 22 there is a partially imaged fluid containing structure in the left lower quadrant, likely a bowel loop.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: Mild basilar atelectasis. Left lung base nodular focus is incompletely characterized. ASD occluder device noted.
1.Focal stricture of the right hepatic duct, increased from prior, and distal common bile duct stricture just proximal to the hepaticojejunostomy, similar to prior. Worsening intrahepatic biliary ductal dilatation. No significant common bile duct dilatation.2.50% narrowing of the portal vein at its anastomosis. Inadequately evaluated hepatic artery. 3. No focal liver lesion. 