Status post ERCP for hilar obstruction (presumed metastatic ovarian cancer) with bilateral stenting, but with persistent conjugated hyperbilirubinemia - rule out dilated intrahepatic ducts. History: rule out dilated (undrained) intrahepatic bile ducts ABDOMEN:LIVER, BILIARY TRACT: There is ill-defined soft tissue encasing the hepatic hilum without discrete measurable mass. The hepatic veins appear patent. There is attenuation of the main portal vein at the bifurcation (4/238) and also attenuation of the central bile ducts. There is bilateral intrahepatic biliary ductal dilatation which is most prominent in the posterior segment of the right hepatic lobe (segment 6) which measures up to 7 mm. The common bile duct is nondilated. The gallbladder is mildly distended. There is a dependent filling defect within the gallbladder which is favored to reflect sludge or stones and does not demonstrate enhancement.SPLEEN: No significant abnormality noted.PANCREAS: The pancreas demonstrates normal parenchymal signal intensity and enhancement. The pancreatic duct is nondilated.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: There are several enlarged retroperitoneal lymph nodes as seen on recent CT.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.
1.Ill-defined soft tissue at the hepatic hilum suspicious for metastasis with associated narrowing of the central portal veins and bile ducts as well as moderate intrahepatic biliary ductal dilatation bilaterally (up to 7 mm) despite biliary stents. 2.Layering debris within the gallbladder which is favored to reflect sludge/cholelithiasis rather than focal wall thickening as questioned on prior ultrasound.