57 years, Male, Reason: ?s/p OLT, w/ perihepatic abscesses, now w/ drain, draining fluid w/ high amylase, eval for pancreatic duct leak History: abd pain, OLT. ABDOMEN:LUNG BASES: No significant abnormality notedLIVER, BILIARY TRACT: Postoperative findings of orthotopic liver transplant There is an intrahepatic pigtail drainage catheter with its tip in the region of the hepatic hilum. A loculated collection extending from the hilum to the posterior aspect of the right hepatic lobe has resolved.Hyper enhancement in the left hepatic lobe on arterial phase images likely represents arterioportal shuntingSPLEEN: Wedge-shaped edema and hypoenhancement within the spleen appears similar to the prior CT and likely represents infarction. Splenomegaly.PANCREAS: T1 hyperintense lesion along the tail of the pancreas measures 1.8 x 1.5 cm (1001/51), previously 2.7 x 1.6 cm and most likely represents hemorrhage. There is mild diffusion restriction within the pancreatic tail which is nonspecific.The pancreatic duct in the tail is mildly dilated, with focal dilatation at the proximal body proximal to an abrupt termination. The pancreatic duct in this region traverses superiorly to the region of the prior fluid collection. The main pancreatic duct is anterior to the distal common bile duct, suggestive of pancreatic divisum at the pancreatic head.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: Mild narrowing of the suprahepatic IVC at the anastomosis is unchanged.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: Mild scattered abdominal ascites.
1.The distal pancreatic duct is mildly dilated and abruptly terminates, traversing superiorly to the region of prior perihepatic fluid collection. A focal pancreatic ductal injury is possible causing the fluid high in amylase. 2.Resolution of perihepatic fluid collection.3.Fluid collection adjacent to the pancreatic tail is decrease in size and is consistent with a hematoma.4.Stable splenic infarct.5.Arterioportal shunting within the left hepatic lobe.