Presentation
A patient with a history of IBD, PSC, and colon adenocarcinoma was referred for follow-up MRCP.
Patient Data
A 10 mm irregular stricture in the mid to distal common bile duct is associated with mild proximal dilation (8 mm).
An 8-mm stricture is seen in the common hepatic duct associated with focal proximal dilatation (7mm).
Segmental strictures extend from the left and right duct confluence to the peripheral segments associated with focal upstream biliary duct dilatations.
The intrahepatic ducts have a beaded appearance, consistent with multiple regions of stricture and dilation.
Intrahepatic duct dilation is most severe in segments VIII and V, suggesting a dominant stricture.
The gallbladder has smooth borders and homogenous contents.
Case Discussion
Primary sclerosing cholangitis with multiple intrahepatic and extrahepatic strictures.
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