59-year-old male with intermittent fever status post combined liver and kidney transplantation. ABDOMEN:LUNG BASES: There is some parenchymal scarring in the right lower lobeLIVER, BILIARY TRACT: Normal transplant liver size. Previously seen 6 mm hyperintense nodule in the left lateral segment is not seen on the current exam. No focal hepatic lesions.Mild to moderate right intrahepatic biliary ductal dilation, slightly increased since prior study and measuring up to 6 mm, previously 5 mm. Mild left intrahepatic biliary ductal dilation is not significantly changed and measures up to 3 mm. A short segment stricture is seen of the right common hepatic duct near Klatskin's point. Biliary enteric anastomosis appears patent. Remnant common bile duct appears similar to prior exam.The hepatic and portal veins are patent; the hepatic artery is patent.SPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: Native atrophic kidneys without hydronephrosis. Complex exophytic cyst in the left native kidney midpole with single thin enhancing septation measuring up to 13 mm (series 103/28).RETROPERITONEUM, LYMPH NODES: Marked focal narrowing of the origin of the celiac artery, most likely due to atherosclerotic plaque.BOWEL, MESENTERY: Post operative changes from biliary enteric anastomosis without evidence of bowel obstruction.BONES, SOFT TISSUES: No significant abnormality notedOTHER: Right iliac fossa renal allograft is partially imaged on noncontrast sequences and demonstrates small T2 hyperintense foci, which are not completely characterized but likely due to cysts.
1. Mild to moderate right and mild left intrahepatic biliary ductal dilation as detailed above. The right-sided biliary ductal dilation has slightly progressed since prior study.2. Marked focal narrowing of the origin of the celiac artery, for which duplex ultrasound is recommended for further characterization.3. 13 mm complex cyst in the left native kidney, for which follow-up is suggested.