27-year-old male with elevated alkaline phosphatase, positive anti-smooth muscle antibody, and ulcerative colitis. Evaluate for primary sclerosing cholangitis. ABDOMEN:LIVER, BILIARY TRACT: Scattered areas of intrahepatic biliary ductal dilatation and stricturing. Subtle biliary ductal wall enhancement is noted on the postcontrast series. Focal stricturing is also seen about the Klatskin point. There is a short segment of smooth stricturing of the distal CBD (approximately 3 cm). No dominant hepatic mass is identified. Normal morphology of the liver.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: No significant abnormality noted.BOWEL, MESENTERY: Subtle enhancement of the colonic mucosa compatible with the history of ulcerative colitis.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.
1.Constellation of findings consistent with primary sclerosing cholangitis.2.No dominant hepatic lesion. No evidence of cirrhosis.3.Subtle enhancement of the colonic mucosa is compatible with the history of ulcerative colitis.