History of primary sclerosing cholangitis. Evaluate for suspicious lesion or dominant stricture. ABDOMEN:LIVER, BILIARY TRACT: The liver measures 23 cm in the craniocaudal dimension, similar to the prior. There is atrophy of the left lateral hepatic segment with compensatory hypertrophy of the right hepatic lobe.Normally distended gallbladder.Demonstrated again is a long smooth stricture involving the common bile duct extending for 3.5 cm with mild proximal dilatation up to 8 mm (series 901/1), similar to the prior. There is mild narrowing just distal to Klatskin's point and mild scattered foci of intrahepatic biliary ductal dilatation and narrowing, similar to prior. There is no significant contiguous intrahepatic biliary ductal dilatation. No discrete suspicious enhancing lesion is noted of the liver parenchyma or involving the common bile duct strictures.The vessels are patent.SPLEEN: The spleen measures 10.7 cm in length without a focal lesion. It is normal in signal intensity.PANCREAS: The pancreas is normal in morphology, signal intensity and enhancement. The main pancreatic duct is normal in caliber with normal variant ductal anatomy.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Right lower quadrant ostomy.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.
Stable examination with findings compatible with primary sclerosing cholangitis with stable distal common bile duct stricture and mild upstream dilatation. No suspicious focal lesion or new dominant stricture.