Presents with right upper quadrant pain. History of liver transplant and biliary stricture. ABDOMEN:LIVER, BILIARY TRACT: Postsurgical changes from a liver transplant. The gallbladder is absent.Subcentimeter segment II and V very hyperintense T2-weighted foci compatible with cysts.No suspicious liver lesion. Mild intra and extrahepatic biliary ductal dilatation with the common duct measuring 9 mm at the porta hepatis, increased from the prior study. There is a focal T2-band near the anastomotic site suspicious for a focal stricture, best seen on series 501, image 18. Distally the duct tapers smoothly to the level ampulla. No filling defect to suggest a mass.The hepatic artery, portal vein and hepatic veins are patent.SPLEEN: No significant abnormality noted.PANCREAS: 8 x 8 mm cystic lesion in the head/uncinate process of the pancreas with lobular margins but no septations, or mural enhancing nodules, unchanged and likely a sidebranch IPMN. Additional relatively stable subcentimeter cystic foci in the pancreatic, body and numerous foci in the pancreatic tail are relatively stable in size and number.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: Stable subcentimeter cyst in the superior pole of the left kidney. No hydroureteronephrosis or suspicious focal lesion.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: Mild bilateral gynecomastia.OTHER: No significant abnormality noted.
1.Interval increase in intra and extra-hepatic biliary ductal dilatation with a focal T2-band near the level of the anastomosis suspicious for a focal stricture. 2.No significant interval change in the multiple subcentimeter pancreatic cystic foci most consistent with sidebranch IPMNs.