History of abdominal pain with elevated alkaline phosphatase. Multiple sequences degraded by patient motion. ABDOMEN:LUNGS: Trace basilar atelectasis/effusions.LIVER, BILIARY TRACT: The liver demonstrates normal parenchymal signal intensity. The hepatic vasculature is not well evaluated given lack of intravenous contrast. There is no significant biliary ductal dilatation within the limitations of motion artifact. The common bile duct measures up to approximately 6 mm. There is cholelithiasis with some pericholecystic fluid which is nonspecific in the setting of ascites. The gallbladder is not distended. There are filling defects within the distal common bile duct (series 401, image 22) compatible with choledocholithiasis.SPLEEN: No significant abnormality noted.PANCREAS: Evaluation of the pancreas and pancreatic duct is severely limited by motion.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: Multiple renal cysts.RETROPERITONEUM, LYMPH NODES: Severe atherosclerosis of the abdominal aorta and its branches.BOWEL, MESENTERY: Bowel wall thickening involving the ascending colon.BONES, SOFT TISSUES: Sternotomy changes. OTHER: Mild abdominal pelvic free fluid, most prominent along the right colon and in the perihepatic space. There is a bladder diverticulum arising from the bladder dome.
1.Examination limited by motion and lack of intravenous contrast.2.Cholelithiasis with some pericholecystic fluid which is nonspecific in the setting of ascites.3.Choledocholithiasis without associated significant biliary ductal dilatation.4.Partially visualized findings of proctocolitis with associated mild abdominal pelvic free fluid as characterized on recent CT.Findings discussed with DAVIES, ANDRE at 9:30 a.m. on 8/29/2016.