There is a well-defined lesion that seems to arise from the medial wall of second part of duodenum, it contains foci of flow void (air locules). It causes a mass effect on the distal C.B.D and distal pancreatic duct, resulting in dilatation of proximal C.B.D (12mm), pancreatic duct (6.5 mm) and intrahepatic biliary tree.
This lesion measures about 3.6x3.9x3.6 cm (AP,transverse,CC).
Features are in keeping with duodenal diverticulum arising from the medial aspect of second part of duodenum resulting in biliary tree obstruction (Lemmel syndrome).
Multiple small gall stones are also noted.