Female 54 years old Reason: h/o HNC, completed CRT, abnormality found on CT History: New intra-and extrahepatic biliary ductal dilatation, cause not identifiable. ABDOMEN:LIVER, BILIARY TRACT: No focal liver lesion. There is intra-and extrahepatic biliary duct dilatation. The common bile duct measures 1.0 cm in maximum dimension. This smoothly tapers toward the ampulla. No discrete measurable lesion is identified. SPLEEN: No significant abnormality noted.PANCREAS: No significant abnormality noted. The pancreatic duct is mildly smoothly dilated to the ampulla. It measures approximately 5 mm.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: There is moderate gastric distention, unchanged compared to recent CT chest.BONES, SOFT TISSUES: No significant abnormality noted.
Persistent intra-and extrahepatic biliary duct dilatation. Smooth dilatation of the common bile duct and pancreatic duct without discrete measurable mass lesion at the ampulla/duodenum. However, particularly given associated mild gastric distension, consideration should be given to ERCP/EUS.