75 year old male patient with elevated total bilirubin. Assess for intrahepatic biliary blockage. ABDOMEN:LIVER, BILIARY TRACT: There are multiple peripherally enhancing hepatic lesions compatible with the patient's known history of metastatic disease. A left hepatic lobe lesion measures 4.7 x 5.7 cm (image 242, series 1201). There is moderate intrahepatic biliary ductal dilatation secondary to an ill-defined, infiltrative mass narrowing the proximal common bile duct over a 2 cm length. The lesion measures approximately 1.8 x 1.4 cm (image 13, series 601). The cystic duct is also partially occluded. There is sludge within the gallbladder.SPLEEN: No significant abnormality noted.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: Left renal cyst and additional bilateral subcentimeter T2 hyperintense foci which may also represent 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.
1.Short segment narrowing of the proximal common bile duct secondary to a surrounding infiltrative mass with moderate intrahepatic biliary ductal dilatation. 2.Multiple hepatic lesions compatible with patient's known metastatic disease. 