87-year-old man with history of chronic cholecystitis. ABDOMEN:LIVER, BILIARY TRACT: There is diffusely decreased signal in the liver, however there is no focal hepatic lesion. The gallbladder is nearly collapsed but contains stones (5/31). Additionally, there is thickening and edema of the gallbladder wall. There is significant extrahepatic and mild intrahepatic biliary ductal dilatation with a large amount of pneumobilia. The common bile duct measures up to 18 mm in diameter (5/32). Additionally, there is an approximately 8 mm round filling defect in the distal common bile duct (12/47) which appears very similar in morphology to that seen on ERCP from 8/26/2016.SPLEEN: No significant abnormality noted.PANCREAS: The pancreatic duct is nondilated. There is no focal pancreatic parenchymal lesion.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: The kidneys are atrophic with multiple large, simple cortical 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.Filling defect in the distal common bile duct, similar in appearance to ERCP from 8/2016 and probably a stone.2.Intra and extrahepatic biliary ductal dilatation with pneumobilia.3.Findings of chronic cholecystitis.