Male 65 years old Reason: Recurrent PSC, weight loss, eval for CCA and dominant strictures History: s/p OLT with recurrent PSC ABDOMEN:LIVER, BILIARY TRACT: Liver has a cirrhotic morphology with widened fissures and a nodular contour. There is biliary ductal dilatation with areas of stricturing. There is stricturing of the bile ducts near the Klatskin point. The common bile duct measures 10 mm. There is mild to moderate intrahepatic biliary ductal dilatation. There are postsurgical changes from hepaticojejunostomy. There is wall thickening and enhancement of the ducts indicating inflammation. The biliary ductal dilatation extends to the level of the biliary enteric anastomosis. Patency of the anastomosis cannot be fully evaluated on this exam. No dominant mass is identified.SPLEEN: No significant abnormality noted.PANCREAS: Subcentimeter cystic focus in the head of the pancreas as seen on image 28/series 10 is likely connects with adjacent duct and may represent a small IPMN.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: Bilateral renal cysts.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.
1.Cirrhotic liver with findings of recurrent sclerosing cholangitis with areas of stricturing and biliary wall thickening. There is no dominant mass. The ductal dilatation terminates at the biliary enteric anastomosis. If patient has findings of jaundice or biliary obstruction, further evaluation for obstruction at this level and the Klatskin point is suggested.