Female 60 years old Reason: hx of biliary dilation on previous MRI/MRCP. ABDOMEN:LIVER, BILIARY TRACT: The liver is normal in morphology. There is no abnormal focal parenchymal enhancing lesion within the liver. There is persistent moderate to severe intrahepatic and extrahepatic biliary ductal dilatation extending to the level of the ampulla. The common bile duct measures 12 mm, previously 13 mm in maximum diameter. The bile ducts are smooth in contour. No definite obstructing mass lesion is noted within the head of the pancreas. The gallbladder is mildly distended. No gallstones or wall thickening is evident.SPLEEN: Small accessory splenule.PANCREAS: Pancreatic parenchyma is atrophic with fatty replacement. The main pancreatic duct is markedly dilated throughout measuring up to 7 mm, previously 8 mm in diameter. The dilatation extends to the level of the ampulla. No definite obstructing mass lesion is evident.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: Left inferior pole simple cyst.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: Left basilar atelectasis.
Persistent biliary and pancreatic ductal dilation to the level of the ampulla without evidence of focal mass lesion. Differential considerations include the benign stricture or nonvisualized obstructing mass. These findings seem somewhat atypical for biliary dilation secondary to narcotic use, as the pancreatic duct is also dilated, however, clinical correlation is indicated.