Reason: 49yo M with h/o ETOH/HCV cirrhosis s/p OLT 2014 c/b rouxeny limb obstruction syndrome and cholangitis. Here w/fever, RUQ pain. Needs further eval History: fevers, RUQ, ABDOMEN:LIVER, BILIARY TRACT:Postsurgical changes of liver transplant. The biliary enteric anastomosis is is patent. No intrahepatic biliary ductal dilatation. The remnant common bile duct is unremarkable. Artifact in the portal vein may be related to air.SPLEEN: Significant splenomegaly measuring 18.3 cm in craniocaudal dimension.PANCREAS: 3 mm T2 hyperintensity in the pancreatic head which communicates with a nondilated pancreatic duct likely represents a sidebranch IPMN.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: Right mid pole T2 hyperintensity is nonspecific without intravenous contrast.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Postsurgical changes of Roux-en-Y jejunojejunostomy. No evidence of obstruction of the Roux limb. There are a few mildly dilated mid abdominal bowel loops not significantly changed from the prior CT.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.
1.Status post liver transplant with normal appearing biliary enteric anastomosis and no evidence of obstruction. Please note that evaluation of cholangitis is limited due to lack of intravenous contrast.2.No evidence of obstruction of the afferent limb.3.Small cyst in the pancreatic head measuring up to 3 mm likely represents a sidebranch IPMN.