History of liver transplant. GI bleed. Evaluate for pseudoaneurysm. ABDOMEN:LIVER, BILIARY TRACT: The patient is status post liver transplant. The liver is normal in morphology and size measuring 17 cm in craniocaudal dimension. Mild decrease in signal intensity on in phase imaging suggesting iron deposition. No intrahepatic or extrahepatic biliary ductal dilatation. The hepaticojejunostomy appears patent. Small volume perihepatic ascites.No suspicious liver lesion.As seen on the prior study the donor common hepatic artery originates from the anterior aorta superior to the celiac axis. The celiac axis demonstrates mild dilatation just distal to its ostium which is nonspecific and unchanged from prior studies. The pulmonary vein and hepatic veins are patent. No specific evidence of pseudoaneurysm. Small periportal lymph nodes are noted.SPLEEN: Mild splenomegaly measuring 16 cm in craniocaudal dimension. 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: Mild dilatation of the celiac artery just distal to its ostium is unchanged.Incompletely evaluated presumed small bowel bowel in the right hemiabdomen demonstrates mild hyperenhancement.BONES, SOFT TISSUES: Mild gynecomastia.OTHER: Moderate left and small right pleural effusion with adjacent compressive atelectasis. Right midlung mass lesion better evaluated on prior CTs.
1.No pseudoaneurysm is identified. A more sensitive evaluation would be a CT angiogram. Alternatively if the patient continues to have symptoms of GI bleeding a CT angiogram or nuclear medicine tagged RBC scan should be considered. 2.Dilatation of the celiac artery just distal to the ostium is unchanged.