Male; 82 years old. Reason: eval for MRCP History: epigastric pain ABDOMEN:LIVER, BILIARY TRACT: Multiple small gallstones within a distended gallbladder. Trace pericholecystic free fluid. No significant gallbladder wall thickening or enhancement. The common bile duct is slightly dilated measuring up to 9 mm. In the distal common bile duct at the level of the ampulla, there is a small T2 dark filling defect seen best on true axial T2 fat saturation sequence, compatible with a stone (series 601/8). Together, the findings are most suspicious for mild obstructive choledocholithiasis.SPLEEN: No significant abnormality noted.PANCREAS: Prominence of the pancreatic duct. No focal pancreatic lesions.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: Left renal cyst and other too small to characterize T2 hyperintense lesion, likely an additional cyst.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: Mild bibasilar dependent subsegmental atelectasis.
Findings most suspicious for mild obstructive choledocholithiasis as detailed above.Findings discussed with ER resident at 1:30 PM on 4/10/15.