RADIOLOGY: KIDNEY: Case# 33004: RENAL INFARCTS. The patient is a 61 year old black female with a history of metallic mitral valve placement and low INR.The patient has a history of 2 to 3 days of nausea and vomiting with a high white blood cell count. 1) Bilateral renal infarcts acute appearing.2) Geometric low attenuation region within the posterior segment of the right hepatic lobe -perfusional vs fat infiltration. 3) Enlarged common bile duct at last 1.1 cm in diameter without a definite mass seen surrounding the duct or within the pancreas. Recommend clinical correlation with liver function tests. An ERCP may be useful for further evaluation. 4) Patchy basal airspace change.