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Gross intra hepatic duct dilatation affecting both the right and left ductal systems. The common bile duct is also distended measuring up to 12 mm. The common bile duct is however not completely visualised. Within the visualised portion, no choledocholithiasis is identified. The gallbladder is distended although no gallstones or gallbladder wall thickening isidentified. Sonographic Murphy's negative.
The head of the pancreas isnot completely visualised due to overlying bowel gas, however the main pancreatic duct was also distended measuring 5 mm.
The liver demonstrates normal echotexture with no focal liver lesions identified.
Bilateral kidneys have a normal appearance. The spleen is normal.
Intra and extrahepatic duct dilatation as well as dilatation of the main pancreatic duct. The distal portion of the CBD was not visualised and thus no cause for this obstruction is identified on the current ultrasound study. Given the patient's elevated bilirubin level, further evaluation with CT or MR is suggested to better interrogate the region of the ampulla.