53-year-old female with elevated AP status post OLT 5/15 status post biliary stent placement for biliary stricture. ABDOMEN:LIVER, BILIARY TRACT: Status post orthotopic liver transplant. The vasculature is patent although the left portal vein is attenuated in appearance, unchanged. Redemonstrated is significant stenosis at the aortic graft to hepatic artery anastomosis. Unchanged small eccentric filling defect within the graft. Mild intrahepatic and extrahepatic biliary ductal dilatation with narrowing at the biliary anastomosis, traversed by interval placement of 2 internalized CBD stents extending into the right hepatic duct. Mild enhancement of the biliary walls. Fatty infiltration. SPLEEN: No significant abnormality noted.PANCREAS: T2 hyperintense cysts in the uncinate process and multiple in the body of the pancreas communicating with the main pancreatic duct compatible with sidebranch IPMNs. ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: Exophytic left renal cyst. Small subcentimeter right cyst. No hydronephrosis.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Diastases of the right oblique muscles.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.
1.Significant stenosis at the aortic graft to hepatic artery anastomosis. Quantification of the stenosis can be done by CTA if needed.2.Mild intrahepatic and extrahepatic biliary ductal dilatation with narrowing at the biliary anastomosis, now traversed by internalized stents. Mild enhancement of the biliary walls may reflect changes from recent stent placement although cholangitis can also be seen in this setting. 