Demographics:
94 years old, Male
Indication:
Jaundice
Findings
- Extrahepatic and central intrahepatic biliary duct dilation with the visualized common bile duct measuring up to 16 mm in diameter
- The distal common bile duct is obscured by bowel gas
- Multiple hypoechoic liver masses, the largest of which measures up to 3.3 cm in the anterior aspect of the right hepatic lobe
- Liver is enlarged, measuring 21.4 cm in craniocaudal span, with diffusely heterogeneous echotexture
- Portal and hepatic veins are patent with antegrade flow
- Cholecystectomy
- Right kidney is partially obscured by bowel gas without evidence of hydronephrosis
- Hypoechoic structure measuring up to 4.6 cm arising from the upper pole of the right kidney with posterior acoustic enhancement, compatible with a cyst
- Pancreas is not well assessed due to overlying bowel gas
- Visualized portions of the abdominal aorta are normal in caliber
- No ascites
Diagnosis
Malignant biliary obstruction
Sample Report
Extrahepatic and central intrahepatic biliary duct dilation, which raises concern for a distal biliary obstruction. Given that the distal common bile duct and pancreas are not well assessed on this study due to bowel gas, recommend contrast-enhanced CT of the abdomen and pelvis for further assessment.
Multiple hypoechoic liver masses, concerning for metastatic disease.
Discussion