Male 58 years old who presented with abdominal pain and jaundice s/p EUS/ERCP 11/18/16 showing choledocholithiasis s/p sphincter tomy, here to evaluate for duct clearance. ABDOMEN:LIVER, BILIARY TRACT: There is an impacted stone at the origin of the right hepatic duct with associated wall thickening, narrowing and likely stricture (series 1501, image 18). This stone correlates with the area of abrupt cut off of at the level of the right hepatic duct on the MRCP images (series 1301 and 1403). There are numerous additional stones within the more proximal right hepatic ducts which are moderately dilated. The left hepatic duct and extrahepatic biliary ducts are normal in caliber.Two subcentimeter right hepatic lesions are slightly hyperintense on T2 and hypointense on T1 and are indeterminant (series 107, image 302).SPLEEN: No significant abnormality noted.PANCREAS: The pancreas enhances homogeneously. The pancreatic duct is not dilated.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: There is a 12 mm, complex cystic lesion in the midpole of the right kidney. No hydronephrosis.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.Impacted stone at the origin of the right hepatic duct with associated wall thickening, narrowing and likely stricture. Numerous additional stones are seen in the more proximal right hepatic ducts which are moderately dilated.2.Subcentimeter right hepatic lesions are indeterminant. Follow-up in 3-6 months is recommended.3.Complex cystic lesion in the right kidney can be followed up with the hepatic lesions.