Presentation
Recurrent abdominal pain.
Patient Data
Age: 70 years
Gender: Male
From the case:
Distal cholangiocarcinoma - common bile duct
{"current_user":null,"step_through_annotations":true,"access":{"can_edit":false,"can_download":true,"can_toggle_annotations":true,"can_feature":false,"can_examine_pipeline_reports":false,"can_pin":false},"extraPropsURL":"/studies/133478/annotated_viewer_json?iframe=true\u0026lang=us"}
Mild intrahepatic duct dilatation. Mild extrahepatic duct dilatation and mural thickening until abrupt transition to soft tissue density. No enlarged lymph nodes.
Right renal cyst.
From the case:
Distal cholangiocarcinoma - common bile duct
{"current_user":null,"step_through_annotations":true,"access":{"can_edit":false,"can_download":true,"can_toggle_annotations":true,"can_feature":false,"can_examine_pipeline_reports":false,"can_pin":false},"extraPropsURL":"/studies/133481/annotated_viewer_json?iframe=true\u0026lang=us"}
Intra- and extra-hepatic duct dilatation. Mid common bile duct stricture with mural thickening and enhancement. CBD wall also demonstrates abnormal restricted diffusion. Distended gallbladder. No enlarged nodes.
Case Discussion
The patient underwent a Whipple procedure, with pathology demonstrating a T1N0 cholangiocarcinoma.
Non-contrast CT requires extra vigilance as the described findings can be easily passed over.