Reason: Cholestasis, rule out biliary obstruction History: bili 20. ABDOMEN:LIVER, BILIARY TRACT: Moderate to severe intrahepatic biliary ductal dilatation, greater in the left lobe than right lobe. Associated left lobe atrophy. There is soft tissue expansion of the main hepatic duct with extension into the right and left hepatic ducts, greater into the left hepatic duct. Left portal vein is not visualized, likely thrombosed. 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 lymphadenopathy.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.
Findings compatible with cholangiocarcinoma at the portal hepatis (Klatskin tumor). Extension into the left hepatic duct greater than right with associated left greater than right biliary ductal dilatation, left hepatic lobe atrophy and left portal vein thrombosis. 