76-year-old male with autoimmune sclerosing cholangitis. Evaluate for cholangiocarcinoma or dominant stricture. ABDOMEN:LIVER, BILIARY TRACT: Cirrhotic liver morphology with nodular surface contour. No focal hepatic lesions. No biliary ductal dilation. Patent portal and hepatic veins.Stable wall thickening of the common duct just proximal to the biliary enteric anastomosis, which is nonspecific and may be related to postoperative change. MRCP images are limited due to large amount of ascites.SPLEEN: Moderate splenomegaly.PANCREAS: Postoperative changes from modified Whipple's procedure, similar to prior exam. Again, the pancreatic duct is mildly dilated with atrophy of the pancreatic pancreatic parenchyma, compatible with chronic pancreatitis. No focal pancreatic lesions are evident.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: Moderately enlarged mesenteric and superior trabecular lymph nodes are not significantly changed.RETROPERITONEUM, LYMPH NODES: Postoperative changes from gastrojejunostomy anastomosis. No evidence of bowel obstruction.BOWEL, MESENTERY: Large amount of abdominal ascites, new since prior exam.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: Redemonstration gastrosplenic and paraesophageal varices.
1.No significant interval change in postoperative findings from modified Whipple's procedure and chronic pancreatitis of the residual pancreas.2.No significant interval change in postoperative changes from biliary enteric anastomosis with stable mild wall thickening of the common duct near the anastomosis, likely related to postoperative change. No biliary ductal dilation.3.Large amount of abdominal ascites, new since prior exam.