History of PSC status post left hepatectomy now with right upper quadrant pain and elevated alkaline phosphatase. Evaluate for infection or obstruction. ABDOMEN:LIVER, BILIARY TRACT: Status post left hepatectomy. Susceptibility artifact near the surgical margin limits evaluation. The residual right hepatic lobe is normal morphology, size, signal intensity and enhancement. Unchanged mild intrahepatic biliary ductal dilatation, likely reflecting patent hepaticojejunostomy. The mild to moderate irregular dilatation is also similar in appearance to the prior exam and is compatible with PSC without a new dominant stricture or discrete lesion. Status post cholecystectomy.SPLEEN: No significant abnormality noted.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: Left renal cyst formation.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: Left adnexal 3.2 cm cyst, only included on coronal T2 weighted imaging sequence, peripheral T2 hypointensity may reflect peripheral calcifications.
1. Stable postsurgical changes from left hepatectomy with stable right intrahepatic ductal dilatation without a discrete obstructive mass although evaluation centrally is limited by susceptibility artifact. Stenosis at the hepaticojejunostomy anastomosis should be considered given the clinical history. No specific evidence of cholangitis as clinically questioned.2. Left adnexal 3.2 cm cyst, only included on coronal T2 weighted imaging sequence, peripheral T2 hypointensity may reflect peripheral calcifications. Lesion is probably benign but if there is any clinical concern, further evaluation with pelvic sonography recommended.I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report.