11-year-old male with history of liver transplant in 2007 with 2 different biliary connections, presenting with transaminitis.EXAMINATION: MRCP with IV contrast 10/28/2016 ABDOMEN:LIVER, BILIARY TRACT: Again seen are changes related to liver transplantation. There is biliary ductal dilatation in the right/anterior segment of the hepatic graft which is connected to the recipient common bile duct, as seen previously. There is also chronic atrophy in the liver segment associated with this bile duct. The biliary ducts of the segment connected to the hepaticojejunostomy limb demonstrate mild enlargement (series 13, image 75-77). The underlying liver parenchyma is homogeneous and enhances normally. No definite biliary stricture is identified. Hepatic artery, portal vein branches and hepatic veins and branches are patent.SPLEEN: There is mild splenomegaly.PANCREAS: The pancreas appears normal without pancreatic ductal dilatation or peripancreatic edema.ADRENAL GLANDS: The adrenal glands are normal in appearance.KIDNEYS, URETERS: There is no hydronephrosis or nephrolithiasis. No focal renal mass is identified.RETROPERITONEUM, LYMPH NODES: No significant lymphadenopathy in the upper abdomen.BOWEL, MESENTERY: Status post findings relating to hepaticojejunostomy. No bowel obstruction.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: There is basilar atelectasis.
1.Again seen is chronic atrophy and obstruction of the anterior transplanted liver segment which is anastomosed to the recipient common bile duct. 2.Mild intrahepatic biliary ductal dilatation in the segment corresponding to the hepaticojejunostomy anastomosis. However, the underlying liver parenchyma in this segment enhances homogeneously. 