62-year-old female with history of biliary stent tube is presenting with abdominal pain and questionable pancreatic mass on outside hospital imaging. Lack of intravenous contrast limits sensitivity for solid organ pathology.ABDOMEN:LIVER, BILIARY TRACT: No suspicious hepatic lesions are evident. Mild to moderate intrahepatic biliary ductal dilation with extensive hepatolithiasis and choledocholithiasis. The common bile duct is distended with calculi and measures up to 2.4 cm. SPLEEN: No significant abnormality noted.PANCREAS: No focal pancreatic lesions evident. No pancreatic ductal dilation.ADRENAL GLANDS: Stable adenomatous hyperplasia of the adrenal glands.KIDNEYS, URETERS: Subcentimeter T2 hyperintense renal lesions are too small to characterize but likely due to cysts. RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.
Biliary tree dilation with extensive hepatolithiasis and choledocholithiasis. Findings are more suggestive of a stricture at the level of the distal common bile duct or impaction from the extensive biliary lithiasis, rather than an obstructing mass. However, evaluation for a mass is limited due to the lack of intravenous contrast.