Reason: 51 yo with abnomral lfts, abdominal pain, gastric bypass, and multipe lesions on RUQ us History: abdomianl pain, elevated lfts, liver lesions ABDOMEN:LIVER, BILIARY TRACT: Status post cholecystectomy. There is a 6 mm stone in the distal common bile duct. The common bile duct is dilated to 9 mm. No intrahepatic biliary ductal dilatation. There are multiple lesions within the liver corresponding to hyperechoic foci on the prior ultrasound which are bright on T2 and demonstrate peripheral nodular enhancement, consistent with hemangiomas. The largest in segment 8 measures 1.5 cm (1301/373).SPLEEN: No significant abnormality noted.PANCREAS: Pancreatic divisum. The main pancreatic duct is nondilated. There are 2 small cystic lesions in the pancreatic head which appear to communicate with the main pancreatic duct measuring 5 mm (901/73) and 6 mm (901/70), likely side branch IPMNs.ADRENAL GLANDS: There is a left adrenal nodule measuring 12 mm with loss of signal on out of phase imaging, consistent with an adenoma (1001/33). The right adrenal appears normal.KIDNEYS, URETERS: There is a 5 mm lesion in the peripheral left mid pole corresponding to hyperechoic focus on the prior exam (801/18). This lesion is dark on fat suppressed T2 sequences and loses signal on out of phase sequences, likely representing a small angiomyolipoma.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Status post gastric bypass with a small hiatal hernia.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.
1.Choledocholithiasis with a 6 mm obstructing stone at the distal common bile duct and dilatation of the common bile duct to 9 mm. 2.Multiple liver lesions likely represent hemangiomas.3.Left adrenal adenoma.4.Pancreatic divisum. 5.Cystic lesions in the pancreatic head measuring up to 6 mm likely represent side branch IPMNs.6.Fat-containing lesion in the left kidney measuring 5 mm likely represents a small angiomyolipoma.