There is a 4.5 mm rounded filling defect at the distal end of the common bile duct, at the papilla level, suggestive of intra ductal stone. The CBD is dilated (8.0 mm) and has some inspissated bile within. Mild intra-hepatic dilatation. No other intraductal stones.
The gallbladder is distended and has thick walls showing diffusion restriction consistent with acute cholecystitis. Multiple gallstones. Small amount of free fluid in the superior abdomen.
The pancreas has normal morphology and signal intensity, there is no abnormal dilatation of the main pancreatic duct. The liver has a normal signal intensity. The spleen, adrenal glands, and kidneys are normal. There is no lymphadenopathy.
Conclusion:
1. Distal 4.5 mm CBD stone and mild biliary tree dilatation.
2. Features consistent with calculous cholecystitis.