Abdominal pain, leukocytosis, right upper quadrant pain. History of PSC. Biliary stent placed 7/16/2015. ABDOMEN:LIVER, BILIARY TRACT: Cirrhotic liver morphology. No T2 hyperintense lesions are seen, though evaluation is limited by lack of IV contrast. The gallbladder is distended, though without specific evidence of cholecystitis. No cholelithiasis or choledocholithiasis. There is diffuse stricturing of the common bile duct, without dominant stricture identified. Intrahepatic biliary ductal stricturing is also noted. No biliary ductal dilation is seen.SPLEEN: Splenomegaly with perisplenic varices.PANCREAS: No significant abnormality noted. The pancreas is normal in signal, without pancreatic ductal dilation.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Prominent loops of bowel in the upper abdomen, which are nonspecific and only partially imaged.BONES, SOFT TISSUES: Multiple T2 hyperintense lesions in the vertebral bodies with cortical lesions on the prior CT, likely representing hemangiomas. OTHER: Small bilateral pleural effusions, right greater than left, with right lower lobe atelectasis. Small amount of complex appearing perihepatic ascites.
1.Diffuse stricturing of the common bile duct, without dominant stricture identified.2.No evident cholelithiasis, choledocholithiasis, or biliary ductal dilation.3.Diffusely dilated small bowel loops in the upper abdomen, partially imaged. This may represent ileus versus small bowel obstruction