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Intra and extra hepatic biliary tree dialatation suggested ERCP in CT abdomen

Resolved Question:

Abdomen and Pelvis CT Scan Results, please advice.
The common bile duct is markedly dilated (2.2cm) till its lower end, where a small ill defined enhanced soft tissue mass is seen causing its abrupt termination.

The liver is normal in size and showed homogenous enhancement with no focal lesion.
There is moderate dilatation of intra hepatic biliary channels.

The gall bladder is greatly distended, but no stone.

The kidneys look normal in size and excrete the contrast adequately, no hydronephrosis.

The pancreas, spleen and adrenals look normal.

No para aortic lymphadenopathy. No ascitis.

No gastric or bowel masses.

The uterus is normal.
Urinary bladder is empty.


Category: Internal Medicine Specialist

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Category: Family Physician-GP
Dr. John Fuller is online now

Expert:  Dr. John Fuller replied 4 Days.

Hello,
Thank you for the consult. 
Since I have only the patients CT results and some blood investigations with me, I will opine on them here.

From the CT report, there appears to be a swelling up of the entire biliary canal (which carries bile) till the end. The reason for the swell up seems to be due a small mass by the end of the canal. This happens to be near the pancreas where the canal ends. What kind of a mass, the extend, the cause etc cannot be made out in the CT. So the recommended approach would be a ECRP – another mode of detailed scanning where the ducts can be closely observed and a biopsy to be taken from the mass leasion. This will give further information into the swelling.

Blood test results show deranged liver function causing jaundice. The jaundice is obstructive type which correlates with the CT results.

I assume that the patient is already under medical care. She will need supportive care now and further imaging studies. Hope this helps.


Dr. John Fuller
Category: Family Physician-GP
Experience: 
MD - New York Institute of Technology, New York College of Osteopathic Medicine
Internship, Family Medicine - Lutheran Medical Center
Residency, Family Medicine - The Mount Sinai Hospital
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