Right upper quadrant pain, abnormal LFTs, cholestasis, concern for choledocholithiasis ABDOMEN:LIVER, BILIARY TRACT: Areas of alternating stricture and dilatation involving intrahepatic biliary system similar in configuration to prior study and extent. Again seen more focal stricturing near confluence of right and left hepatic ducts. Degree of ductal dilatation in periphery of liver mildly increased. For example, hypointense subcentimeter focus seen in hepatic segment 2/3 on image 46 series 1002 likely portion of dilated intrahepatic bile duct, measures 6 mm. Common bile duct normal in size, configuration similar to earlier study. No intraluminal signal void seen to suggest choledocholithiasis. No suspicious liver lesion delineated.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: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality noted.
1. Areas of alternating stricture and dilatation involving intrahepatic biliary system similar in configuration to prior study and extent. Again seen more focal stricturing near confluence of right and left hepatic ducts. Degree of ductal dilatation in periphery of liver mildly increased. Findings compatible with primary sclerosing cholangitis. 