Help with these MRCP Results please!!!?!


Question: Help with these MRCP Results please!!!?
FINDINGS:The Extrahepatic bile ducts are mildly dilated for the patients age,with the common hepatic duct measuring up to 9mm on a series 10 image 9.

*There is also mild prominence of the central intrahepatic duct. No intraductal filling defects are seen. The pancreatic duct is non-dilated and pancreatic duct is nondilated and the pancreatic ductal anatomy appears classic.

*There is a duodenal diverticulum seen just anterior to the to the distal common bile duct adjacent to the pancreatic head. The gallbladder is normal in appearance with no gallbladder stones seen.

*In the inferior right hepatic lobe is am 8mm T2 hyper intense lesion which is not fully characterized best seen on the M.R.C.P. images,

*tiny foci of markedly bright T2 signal likely representing hepatic cysts seen in the liver dome,lateral left hepatic lobe,and in the more inferior left hepatic lobe. These measure 3 to 4 mm in diameter. No focal pancreatic lesions are seen on this non contrast study.

*The spleen, adrenal glands, and kidneys are normal. There is a rectus diastasis and evidence of a prior mid-line surgical incision with probable mesh repair, not fully imaged.

*Abdominal wall incisional hernia with complete rectus diastasis with significant progression in comparison with prior CT study done on 3/7/2011

IMPRESSION:
1) Mild biliary ductal of unclear etiology. No evidence of choledocholithiasis or

cholecystics. Suggest correlation with liver function studies.
2) Duodenal diverticulum seen just anterior to the to the distal common bile duct adjacent to the pancreatic head.
3) nonspecific T2 hyperintense lesion in the inferior right hepatic lobe. The absence of any history of malignancy. this is likely to represent a hemangioma. Several tiny hepatic cysts are incidentally noted.
4) Rectus diastasis with the probable prior mesh repair of the anterior abdominal wall. hernia also present

Answers:

Background:
The liver has different lobes. The main right lobe is larger
and more to the right side of the patient. The left lobe is
smaller in size, connected to the right lobe, and extends
over toward the middle of the body. The other lobes are
not mentioned here (so I will omit them).

Cysts can be fluid filledsacs, complex(meaning they have
something inside them more than just fluid), or [rarely] they can be
cancerous. Cysts are just usually watched closely to see if
they enlarge in size. If they stay the same...it is good.
If they enlarge to a certain size where they may damage the
liver cells around them...they may have to be removed or
a portion removed to drain them.

Now, about the ducts:
The liver makes bile. This bile flows through tube like structures,
known as ducts. The ducts inside the liver are the intrahepatic
duct (intra means inside and hepati means the liver).
***Your ducts, inside the liver, are well seen, and the bile
is flowing through them okay***
The bile flows through these ducts to the outside of the liver
to the gallbladder to be stored and concentrated.
When you eat, the food moves from the mouth, to the
esophagus, to the stomach, and then over to the first
part of the intestines (known as the duodenum).
Hormones are then released, and this makes the
gallbladder contract and push the bile into the "common
bile duct" [the main extrahepatic duct outside the liver...
extra mean outside)
***The ducts outside the liver appear to be dilated.***
The bile flows to the intestine (the first part known as
the duodenum) to help emulsify the fats we eat so they
can be digest and absorbed.

Right before the common bile duct connect to the
intestines, the duct from the pancreas connects to the
common bile duct. It appears to be normal, not dilated.
The pancreas is located more toward the center of
the abdomen...behind the stomach area.

A duodenum diverticulum is an outpouching of the
intestines. If you think of the skin being irritated and
a blister forms on the surface that seems to fill up...
this is what it may look like in the intestines. However,
the blister is more like a open place where the
contents of the intestines can gather into.
They see the diverticulum is located to the front of
where the bile duct comes down to connect to the
intestines...but, it is about even with the Pancreas
head, which would be above it. (they are trying to
state here, the approximate location). Your pancreas
appears to be just fine.

The right lobe of the liver, they see a lesion which
they believe to be a Hemangioma. Though, they are
not sure. An Hemangioma is a group of blood vessel
in a cluster like form...they are usually not a cause of
true concern..if this is what it truly is. They do see
cysts in different areas of the liver.

They do not see any stones (choledocholithiasis),
growths, malformation, infections anywhere.
However, they do see a hernia.
And you may of had some other repair done, that they
have taken notice of.

Your spleen, kidneys, and adrenal glands appear to be
fine.

I hope this better explains things to you. Best wishes
Only the doctor, with further testing or looking at your past
tests done...can determine your diagnosis and "true" results.
No one test, by itself, is 100% accurate.

caregiver to a liver transplant patient



It has all of the findings listed under the "impressions" section at the bottom. What specifically are you not understanding? Ill go over the basics.
1.Small amount of nonspecific widening of your bile duct(It goes from the pancreas to the liver)

2.Duodenal diverticulum is an outgrowth or "bulge/pouch" on the bile duct where it connects to the pancreas. Diverticula can become areas for bacteria to congregate as well as become full of minerals and eventually become blocked.

3. A lesion (they think it is an hermangioma--a harmless grouping of tiny blood vessels) on your liver along with some pinhead sized cysts(again harmless)

4.Noted your previous hernia site and repair.

I hope I was able to make thing a little more clear for you but you really should be asking your physician for an interpretation and possible implications for your health. Good Luck.




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