Male; 61 years old. Reason: cholelithiasis; choledocholithiasis; common bile duct dilation History: RUQ abdominal pain; fevers; elevated total bilirubin, ggt, elevated AST/ALT ABDOMEN:LUNG BASES: Trace right pleural effusion. Stable right lower lobe peripheral air space opacity suspicious for infarct with central increased T2 hyperintensity, suggesting necrosis (partially visualized); underlying infection cannot be excluded.LIVER, BILIARY TRACT: Unchanged diffuse hepatic metastatic disease.Cholelithiasis. No significant gallbladder wall thickening or enhancement. Mild pericholecystic free fluid is likely related to generalized ascites with mild perihepatic ascites seen. Normal caliber of the biliary tree. No choledochalithiasis.SPLEEN: No significant abnormality noted.PANCREAS: Unchanged pancreatic body mass, most compatible with pancreatic adenocarcinoma. Stable focal stenosis of the splenic vein posterior to the mass to compression by the mass.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: Stable gastrohepatic lymphadenopathy.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: Mild abdominal ascites.
1.No significant interval change in multiple findings since CT exam performed yesterday, including right lower lobe infarct, diffuse hepatic metastatic disease, pancreatic mass, and abdominal lymphadenopathy.2.Normal caliber of the biliary tree without evidence of choledocholithiasis or obstruction.3.Cholelithiasis without specific evidence of acute cholecystitis.