52-year-old female status post liver transplant with elevated bilirubin. Evaluate biliary tree. ABDOMEN:LUNG BASES: Moderate right and small left pleural effusions with underlying bibasilar atelectasis, partially visualized.LIVER, BILIARY TRACT: Postsurgical changes from liver transplantation. No focal hepatic lesions.Mild to moderate bilobar intrahepatic biliary ductal dilation with dilation of the common duct measuring up to 8 mm. There is an apparent transition point at the biliary enteric anastomosis, which appears narrowed.Hepatic and portal veins are patent.SPLEEN: No significant abnormality noted.PANCREAS: Mild atrophy of the pancreas. There are multiple small cystic foci throughout the pancreas, several of which demonstrate connection to the main pancreatic duct. These are most compatible with small branch type intraductal papillary mucinous neoplasms. No suspicious features. Normal caliber of the main pancreatic duct. For future reference, the largest at the posterior aspect of the pancreatic head measures 16 x 13 mm (series 5/26).ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: Left renal simple cyst.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Enteric tube tip in distal duodenum.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: Mild upper abdominal ascites and body wall anasarca.
1.Intra and extrahepatic biliary ductal dilation with narrowing at the biliary enteric anastomosis, which may be due to edema given recent transplantation.2.Multiple small pancreatic branch type IPMNs, for which follow-up imaging is recommended.