Reason: Please evaluate liver and biliary system for signs of PSC. History: 27 yo M with Crohn's disease , and an unverified report of PSC, now admitted with abdominal pain, nausea, and severely elevated Alk phos and (intrahepatic?) biliary dilation. ABDOMEN:LIVER, BILIARY TRACT: No suspicious focal hepatic lesions. No significant change in the mild irregularity and prominence of the central intrahepatic biliary ducts without dominant stricture or mass. The common bile duct measures up to 9 mm, stable. 1.4 cm cholelithiasis again noted. Portal and hepatic veins are patent.SPLEEN: Mild splenomegaly measuring up to 13.5 cm.PANCREAS: No significant abnormality noted. No pancreatic ductal dilatation or mass.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: Atelectasis/consolidation at the lung bases.
1.No significant change in appearance of the biliary system with mild irregularity as above.2.Cholelithiasis without evidence of acute cholecystitis.3.Stable mild splenomegaly. 4.Atelectasis/consolidation at the lung bases.