Reason: evaluate for choledocholithiasis History: reported CBD stone with unsuccessful removal during ERCP 1 wk here with AMS, abnormal LFTs ABDOMEN:LIVER, BILIARY TRACT: Small perihepatic and pericholecystic fluid. Dilated common bile duct measuring up to 1.3 cm. Tiny stones in the dilated common bile duct (series 4 image 38). No focal hepatic lesion is identified.SPLEEN: Small T2 hyperintense lesion in the spleen, presumably cyst. Splenule adjacent to the splenic tip.PANCREAS: There is fat stranding around the pancreatic head, compatible with pancreatitis, which may be postprocedural due to recent ERCP or stone related. Distal pancreatic duct is narrowed approximately 9 mm proximal to the ampulla insertion, which may be related to parenchymal edema. There is adjacent duodenal wall thickening, likely reactive.Multiple small IPMNs in the pancreatic head/proximal body. Accessory duct noted, an anatomic variant.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: Left renal cyst and right T2 hyperintense lesion, too small to characterize. There may be bifurcation of the left renal vein with circumaortic morphology.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: Bilateral small pleural effusions with adjacent atelectasis.
1.Dilated common bile duct with tiny stones. 2.Mild proximal pancreatic duct narrowing and pancreatitis of the pancreatic head, which may be postprocedural given recent ERCP or related to stone.3.Findings discussed with Megan Meiklejohn, PA. 