Abnormal LFTs. Clinical concern for cholangitis. Patient also has history of cholangiocarcinoma. ABDOMEN:LIVER, BILIARY TRACT: There is poorly defined increased T2 signal surrounding the intrahepatic bile ducts, left greater than right. This is a nonspecific finding but can be seen in the setting of inflammation/cholangitis. The left hepatic ducts are moderately dilated which accounting for differences in technique appears similar to most recent CT. The common bile duct has a stent in place, and there is debris proximal to and within the stent. Again seen is poorly defined soft tissue thickening the surrounding the distal common bile duct which measures 2.5 x 1.8 cm in maximum axial dimension compatible with the patient's known tumor.SPLEEN: No significant abnormality noted.PANCREAS: Mild pancreatic atrophy. No pancreatic ductal dilatation.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: Unchanged ablation defect in the interpolar region of the right kidney.RETROPERITONEUM, LYMPH NODES: No upper abdominal lymphadenopathy.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: Right lateral abdominal wall broad-based hernia containing mesenteric fat and nonobstructed ascending colon.OTHER: Basilar subsegmental atelectasis and trace right pleural effusion.
1.Soft tissue mass surrounding the common bile duct compatible with the patient's known tumor appears similar to prior. There is left greater than right intrahepatic biliary ductal dilatation also not significantly changed. These bile ducts have surrounding increased T2 signal which is nonspecific but may be seen in the setting of inflammation/infection.