Presentation
Yellow discoloration of the eyes and skin with itching and abdominal distension.
Patient Data
There is a definable, hyperdense lesion (as compared to the adjacent duodenal wall) of about 3.0 x 1.2 cm in the ampullary region with retro-grade dilatation of the CBD (up to 27.0 mm at mid-part) and main pancreatic duct (up to 10.0 mm at the head region suggestive double duct sign. Pancreatic parenchyma appears unremarkable.
Intra-hepatic biliary channels are also markedly dilated.
The liver is mildly enlarged in size with a normal position and irregular outline however, no discrete focal lesion is appreciated in hepatic parenchyma. The hepatic and portal veins are patent.
The gall bladder is distended (13.2 x 5.3 cm), however no definite mass lesion or calculus is seen.
A massive amount of free fluid is seen in the abdominopelvic cavity.
No bony lesion is appreciated.
Case Discussion
Current CT findings are in favor of ampullary mass lesion rather other entity with upstream dilatation of the CBD (with intra-hepatic biliary channels dilatation) and main pancreatic duct (double duct sign), gall bladder hydrops, and ascites as described above
Unable to process the form. Check for errors and try again.