31-year-old male with liver lesions, cirrhosis, status post orthotopic liver transplant. ABDOMEN:LIVER, BILIARY TRACT: Postsurgical appearance of an orthotopic liver transplant are noted. Cirrhotic liver morphology. No suspicious liver lesions. The intrahepatic portal vein and hepatic veins are patent. There is a changing caliber at the confluence of the splenic vein and SMV. The splenic vein is chronically thrombosed with large splenic varices. There are large collaterals the region of the SMV.SPLEEN: Evidence of portal hypertension and chronic splenic vein thrombosis with large varices and splenomegaly measuring up to 26 cm. Low T1 and T2 punctate foci scattered throughout the spleen may represent Gamna-Gandy bodies.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: Small volume ascites an diffuse mesenteric edema is present, decreased since the prior exam. Small bowel caliber is within normal limits without evidence of obstruction.BONES, SOFT TISSUES: Fluid containing umbilical hernia.OTHER: Small right and trace left pleural effusions.
1.Change in caliber at the confluence of the SMV and splenic vein (varices) which may represent a site of anastomosis or a potential partial thrombosis of the SMV. The intrahepatic and central portal portal vein is patent.2.No suspicious focal liver lesions.3.Other findings as above.