Evaluate for biliary obstruction or cholestatic liver disease. Status post heart transplant. Persistent elevated alkaline phosphatase. ABDOMEN:LIVER, BILIARY TRACT: Unchanged intrahepatic ductal dilatation, left greater than right, and mild extrahepatic ductal dilatation. The common bile duct measures 9 mm, unchanged. Similar appearing stricture at the ampulla is again identified (series 4, image 85). No focal mass lesion is identified. Low insertion of the cystic duct. Patient is status post cholecystectomy.SPLEEN: No significant abnormality noted.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: Status post median sternotomy.
Intra and extrahepatic biliary ductal dilatation with distal common bile duct stricture, similar to prior.