History of fever and nausea. Evaluate for biliary obstruction. ABDOMEN:LIVER, BILIARY TRACT: The liver is normal in morphology and size. The hepatic and portal vessels are patent.There is at least mild narrowing at the biliary-enteric anastomosis with interval increase in now moderate intrahepatic ductal dilatation.The previously seen circumferential thickening of the bile duct system and mild postcontrast enhancement and restricted diffusion has resolved.No focal suspicious lesion. Vague regions of geographic wedge-shaped peripheral hyperintensity with associated arterial enhancement likely represent perfusion anomalies.SPLEEN: Mild splenomegaly without focal lesion.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: Small left renal cysts. Small right proteinaceous/hemorrhagic cyst. No hydronephrosis.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: Postsurgical changes of anterior pelvic wall.OTHER: Trace right pleural effusion. Minimal basilar atelectasis.
Mild narrowing at the biliary enteric anastomosis with interval increase in now moderate intrahepatic ductal dilatation may represent a stricture. Reflux is also consideration. Interval resolution of the bile duct system wall thickening and enhancement. 