32-year-old male with history of ulcerative colitis with elevated LFTs and concern for primary sclerosing cholangitis. Evaluate. ABDOMEN:LIVER, BILIARY TRACT: No focal hepatic lesion is identified. The gallbladder remains distended measuring 5 cm. There is smooth tapering of the very distal common bile duct near the level of the ampulla which raises suspicion for a distal common bile duct stricture. The common bile duct measures up to 9 mm with mild intrahepatic biliary ductal prominence; this finding is unchanged compared to the previous examination. No specific evidence of intrahepatic biliary ductal irregularity or stricturing.Hepatic vasculature is patent.SPLEEN: No significant abnormality noted.PANCREAS: No pancreatic ductal dilatation.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: No hydroureteronephrosis. The kidneys enhance symmetrically.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.Findings raise suspicion for distal common bile duct stricture near the level of the ampulla. 2.No intrahepatic biliary ductal dilatation or irregularity.