25-year-old female patient with primary sclerosing cholangitis. Evaluate for cholangiocarcinoma. ABDOMEN:LIVER, BILIARY TRACT: There is mild interval decrease in distention of the gallbladder. Again seen is diffuse multifocal stricturing and narrowing of the biliary tree with associated atrophy and fibrosis of the right lobe of the liver.There is long segment narrowing of the common bile duct distal to the confluence of the common hepatic and cystic ducts (series 9 image 85), similar to prior. The intrahepatic biliary ducts appear unchanged compared to prior. No cholelithiasis.Hepatomegaly, measuring up to 22 cm in craniocaudal dimension.The intrahepatic portal veins are patent but attenuated.No abnormal enhancing lesions.SPLEEN: Mild splenomegaly and splenic varices, unchanged.PANCREAS: There is distal pancreatic duct dilatation, measuring up to 5 mm in maximal diameter, with associated narrowing of the pancreatic duct in the mid pancreatic body.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: No significant abnormality noted.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.Multifocal stricturing and dilatation of the pancreaticobiliary tree appear similar compared to prior examination.2.Long segment stricturing of the distal common bile duct with mild interval decrease in gallbladder distention.