Male 64 years old s/p combined liver/kidney transplant in June 2013. Evaluate for changes in known IPMN. ABDOMEN:LIVER, BILIARY TRACT: Stable postsurgical changes of liver transplant. There is again mild narrowing at the level of the biliary duct anastomosis and mild intrahepatic biliary ductal dilatation. The proximal hepatic artery, portal venous system and hepatic veins appear patent. The distal branches of the hepatic artery are not well visualized as on previous exams. The liver parenchyma is normal signal intensity. There is a new 18 x 16 mm focus of arterial phase enhancement in hepatic segment 7 that normalizes on later phases of contrast with no washout consistent with perfusion abnormality. No suspicious liver lesion.SPLEEN: No significant abnormality noted.PANCREAS: Stable 8 mm T2 hyperintense focus within the pancreatic head (series 901, image 11) remains nonspecific but compatible with a side branch intraductal papillary mucinous neoplasm. The pancreatic duct is nondilated. Normal pancreatic parenchymal signal intensity and enhancement.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: Atrophic native kidneys. No change in a 2 cm left lower pole renal cyst and mild left greater than right perinephric stranding.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: Mild bilateral gynecomastia, unchanged.
1.Stable postsurgical changes of liver transplant.2.No change in mild narrowing of the biliary anastomosis.3.Stable nonspecific 8 mm cystic pancreatic head lesion likely represents a sidebranch IPMN.