Female 74 years old with epigastric pain radiating to back 1 month ago, abnormal liver tests, and cholelithiasis on abdominal ultrasound. Liver tests are now normal but she has intermittent epigastric pain. Assess for choledocholithiasis, pancreatitis. ABDOMEN:LIVER, BILIARY TRACT: No focal liver lesion, biliary ductal dilation, or ascites. Cholelithiasis. A subcentimeter T2 hypointense focus within the distal common duct (series 7, image 33) consistent with a nonobstructing stone (no upstream extrahepatic or intrahepatic biliary duct dilatation seen), focus is identical in appearance and signal to stones seen in gallbladder. There is no evidence of acute cholecystitis.SPLEEN: No significant abnormality noted.PANCREAS: There is mildly decreased intrinsic T1 signal of the pancreas, nonspecific but may represent sequela of prior pancreatitis.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: No retroperitoneal lymphadenopathy.BOWEL, MESENTERY: Inverted duodenal sweep better depicted on prior small bowel follow-through.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.
1.Nonobstructing distal common bile duct stone seen.2.Cholelithiasis, without evidence of acute cholecystitis.