Abdominal pain in patient with history of liver transplant. ABDOMEN:LIVER, BILIARY TRACT: No focal hepatic lesions are identified. The common hepatic duct appears dilated upstream to the anastomoses measuring up to 12 mm in diameter, not significantly changed. There is mild, diffuse intrahepatic biliary ductal dilatation which may have been seen on the prior study.The intrahepatic portal veins appear patent. There is once again significant narrowing of the portal vein at the confluence which remains patent (series 9, image 170) and appears similar to 2012 exam. The splenic vein and superior mesenteric vein appear patent. The hepatic veins appear patent. Evaluation of the hepatic arteries is somewhat limited by suboptimal arterial phase timing. The conduit connecting the hepatic arteries to the infrarenal aorta remains patent. The IVC is severely narrowed at the level of the hepatic anastomosis with dilation of the IVC just inferior to this level.SPLEEN: The spleen is mildly enlarged measuring up to 13.6 cm, previously 17.7 cm. An approximately 1 cm lesion within the superior aspect of the spleen which demonstrates peripheral, nodular enhancement is compatible with a hemangioma.PANCREAS: Pancreatic duct is nondilated.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: Previously seen ascites has resolved.PELVIS:UTERUS, ADNEXA: Normal variant nabothian cysts are present in the cervix.BLADDER: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: Previously seen ascites has resolved.
1.Postsurgical changes of liver transplant. Persistent narrowing at the portal vein confluence which remains patent. Evaluation of the hepatic arteries is suboptimal due to timing of arterial phase, but the hepatic artery conduit remains patent.2.Improving splenomegaly and resolution of ascites.