History of orthotopic liver transplant and renal transplant in June 2013, evaluate for changes in known IPMN. ABDOMEN:LIVER, BILIARY TRACT: Postsurgical changes of liver transplant. The liver demonstrates normal signal intensity without suspicious focal lesions. There is mild narrowing at the site of biliary duct duct anastomosis appearing similar to prior. No significant intrahepatic or extrahepatic biliary ductal dilatation. The distal branches of the hepatic artery are not well-visualized, similar to prior. The proximal hepatic artery, portal venous system, and hepatic veins appear patent.SPLEEN: No significant abnormality noted.PANCREAS: There is a 8 mm T2 hyperintense focus within the pancreatic head (series 9, image 37) which is nonspecific but compatible with a sidebranch intraductal papillary mucinous neoplasm, unchanged compared to 4/22/2014 (series 4, image 16). The pancreas demonstrates normal signal intensity and enhancement. The pancreatic duct is not dilated.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: Atrophic kidneys. Stable 2 cm lower pole left renal cyst. Mild left greater than right perinephric stranding appearing similar to prior. No hydronephrosis.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: Small bilateral gynecomastia.
1.Postsurgical changes of liver transplant with unchanged mild narrowing at the biliary anastomosis, unchanged. 2.8 mm cystic lesion within the pancreatic head which is nonspecific but likely represents a sidebranch IPMN, unchanged.