History of elevated LFTs and abdominal pain. History of liver transplant. ABDOMEN:LIVER, BILIARY TRACT: Postsurgical changes from an orthotopic left liver lobe transplant. There is moderate intrahepatic biliary ductal dilatation with a 1.1 x 0.9 cm filling defect proximal to the hepaticojejunostomy compatible with obstructive hepatolithiasis. There is probable narrowing at the hepaticojejunostomy accounting for stasis and stone formation. There is trace perihepatic ascites. No abnormal T2-weighted signal intensity or restricted diffusion to suggest cholangitis, although evaluation is limited by lack of intravenous contrast. No focal suspicious liver lesion.SPLEEN: Mild splenomegaly measuring 15 cm in craniocaudal dimension with minimal perisplenic fluid.PANCREAS: No significant abnormality noted.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: There is a small central right diaphragmatic defect with herniation of retroperitoneal fat.OTHER: No significant abnormality noted.
Hepatolithiasis with downstream moderate intrahepatic biliary ductal dilatation with suspected narrowing at the hepaticojejunostomy accounting for stasis and stone formation. No specific findings of cholangitis although evaluation is limited by lack of intravenous contrast.Trace ascites. Mild splenomegaly. Small right diaphragmatic defect with herniating retroperitoneal fat.