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CT Abd Pyelonephritis

Findings: Normal contrast enhanced appendix is seen in the right lower abdomen. The intestine demonstrates normal course and caliber. The left kidney appears heterogeneous in attenuation, increased in size when compared to the right, and demonstrates subtle perinephric stranding, suspicious for pyelonephritis. There is a 7 cm low-attenuating lesion in the posterior segment right hepatic lobe, suspicious for hemangioma, as demonstrated on recent ultrasound. The pancreas, spleen, adrenal glands, right kidney, and bladder appear unremarkable. There is no evidence of mass or pathological fluid collection in the pelvis. The opacified portions of the gastrointestinal tract are unremarkable. There is no lymphadenopathy. The osseous structures are unremarkable. Minimal left greater than right posterior pleural thickening are noted. Bilateral breast augmentation changes are noted. Impression: 1. Findings are suspicious for left pyelonephritis. 2. Probable hemangioma in the posterior segment of the right hepatic lobe. Recommend liver MRI or triphase liver CT for further evaluation. 3. Slightly enlarged common bile duct (6 mm), concordant with findings on gallbladder ultrasound.