49-year-old female. Status post liver transplant, hyperbilirubinemia. EPIC history: liver transplant 3/10, 3/11 for subcapsular hematoma, 3/23 for abdominal washout and liver biopsy for work-up of cholestasis. ABDOMEN:LIVER, BILIARY TRACT: Post surgical findings of a liver transplant. Surgical drain terminates over the anterior right hepatic dome and a new drain has been placed adjacent to the left hepatic lobe. Perihepatic packing material appears to have been removed with residual peripheral T1 hyperintensity at the lateral aspect of the liver that likely represents residual hematoma. Heterogeneous signal in segment 7 of the liver is concerning for an infarct. Very mild scattered intrahepatic biliary ductal dilatation.Limited evaluation of the hepatic vasculature on this noncontrast exam. Normal vascular flow-voids of the portal vein and hepatic veins are present on T2 sequences. The common hepatic artery signal flow void is seen 1 cm from its take off from the celiac axis; the rest of the artery is not visualized. SPLEEN: Splenomegaly measuring 17.1 cm. Peripheral heterogeneous signal in the spleen is concerning for splenic infarcts.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: Infrarenal IVC filter.BOWEL, MESENTERY: Proximal small bowel dilatation up to 4.3 cm with a partially collapsed distal terminal ileum, concerning for a partial small bowel obstruction. Nonspecific small bowel wall thickening. Enteric tube terminates in the proximal jejunum.BONES, SOFT TISSUES: Anasarca. Midline skin staples.OTHER: Small amount of abdominopelvic ascites.
1.Very mild scattered intrahepatic biliary ductal dilatation. Hepatic veins and portal vein are patent with normal vascular flow voids. Common hepatic artery flow void is seen 1 cm from its take-off from the celiac axis, rest of the artery is not well-visualized. 2. Findings concerning for a segment 7 hepatic infarct and multiple splenic infarcts.3. Dilated small bowel likely due to a partial small bowel obstruction.4. Small amount of ascites.