Elevated LFTs after liver transplant. History of cryptogenic cirrhosis. ABDOMEN:LIVER, BILIARY TRACT: Postsurgical changes from an orthotopic liver transplant. The liver is normal in size, morphology, intensity and enhancement. The portal veins are patent. The hepatic artery is suboptimally evaluated due to susceptibility artifact. The intrahepatic branches are opacified. No suspicious liver lesion.There is mild intrahepatic and extrahepatic biliary ductal dilatation including focal narrowing at the level of the anastomosis (series 7/143), similar to prior study. The common bile duct measures approximately 7 mm. There is also smooth focal narrowing near the anastomosis, raising the possibility of ampullary stenosis. No focal mass or stone.SPLEEN: No significant abnormality noted.PANCREAS: Mild pancreatic atrophy. Several small T2-weighted hyperintense cystic foci, some of which appear to communicate with the main pancreatic duct, compatible with side-branch type intraductal pancreatic mucinous neoplasms without suspicious imaging features. The largest is in the pancreatic head measuring 9 mm (series 4/22).ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: Left renal simple cyst.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.
Stable examination with mild intra and extra-hepatic biliary ductal dilatation. Stable mild narrowing at the biliary anastomosis and findings raising the possibility of ampullary stenosis/benign stricture without a mass or stone. Several pancreatic cystic foci, likely multiple side-branch type IPMNs without suspicious imaging features.