FINDINGS:   Lower thorax: Dependent atelectasis in the lung bases.   Liver and biliary tree: Normal. The hepatic and portal veins are  patent. No intrahepatic biliary duct dilatation.   Gallbladder: Normal. The common bile duct measures up to 8 mm in  diameter, but tapers distally.   Spleen: Normal.   Pancreas: Normal.   Adrenal glands: Normal.   Kidneys and ureters: Multiple small hypodense lesions in both  kidneys, likely representing cysts. No hydronephrosis or  obstructing renal stones.   Gastrointestinal tract: Normal. The appendix is normal. No  significant diverticulosis or evidence of diverticulitis. No evidence  of obstruction.   Peritoneal cavity: No free fluid.   Bladder: Normal.   Uterus and ovaries: Normal.   Vasculature: Atherosclerotic changes without aneurysm.   Lymph nodes: Inguinal and left paraaortic nodes are prominent, but not enlarged  by size criteria. There are three mesenteric lymph nodes measuring up to 12 mm, worsening compared to prior CT.   Abdominal wall: Normal.   Musculoskeletal: Degenerative changes of the lower  thoracic and lumbar spine, stable compared to prior imaging. Portal vein shows approximately 50-60% narrowing at the porta hepatis. Pelvic vasculature is not adequately characterized on this study.
1.  No evidence of obstruction, diverticulitis, appendicitis,  nephrolithiasis, or other acute findings to explain the patient's  clinical symptoms.
