Findings:
- There is marked dilatation of intrahepatic bile ducts and the common hepatic duct with the common hepatic duct measuring up to 12mm in transverse diameter.
- There is abrupt narrowing at the junction of common hepatic ducts and common bile duct with the distal bile duct being normal in calibre.
- The gallbladder is contracted.
- The spleen and pancreas are normal apart from some dilatation of the pancreatic duct throughout as well as extensive vascular calcification involving mesenteric vessels. .
- No para-aortic lymphadenopathy.
Conclusion:
- Substantial dilatation of intra-hepatic bile ducts and common hepatic duct with high suspicion of mass involving the bile duct at the junction of the common hepatic duct and common bile duct. The findings are very suspicious for diagnosis of primary neoplastic lesion involving the bile duct at this site.
- More distal to the mass lesion the common bile duct is decompressed.
- The gallbladder is contracted.
- Some dilatation of pancreatic duct throughout it's length.
- Surgical opinion would be indicated in view of the findings. Further investigation by MRCP would be indicated in order to more fully asses the bile ducts and to confirm or exclude the presence of mass lesion at the junction of the common hepatic duct and common bile duct (KLATSKIN tumour).