Female 71 years old Reason: rule out infectious process, abscess, fistula History: fever, E.coli bacteremia, dilated common bile duct on imaging ABDOMEN:LIVER, BILIARY TRACT: There is proximal mild to moderate intrahepatic biliary ductal dilatation as well as extrahepatic biliary ductal dilatation. Biliary ductal wall thickening and enhancement with associated peribiliary restricted diffusion and patchy T2 signal is concerning for cholangitis.Multiple stones are present within the distal common bile duct measuring approximately 2.0 x 0.8 cm. Punctate foci of high T2 signal within the gallbladder fundus suggests adenomyomatosis.The gallbladder wall is mildly thickened and the gallbladder contains stones.SPLEEN: No significant abnormality noted.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: Scattered small retroperitoneal lymph nodes are not pathologically enlarged by size criteria. There is atherosclerotic plaque along the aortic wall.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: Multifocal linear high signal within the anterior body wall likely reflects postsurgical change. OTHER: No significant abnormality noted.
1.Obstructive distal common bile duct stones resulting in intrahepatic and extrahepatic biliary ductal dilatation.2.Biliary ductal wall thickening and enhancement as well as peribiliary restricted diffusion and patchy high T2 signal concerning for cholangitis. No liver abscess or parenchymal infection is evident.