Do these findings explain the patient's symptoms?
The bloods, history and imaging are suggestive of an obstructive picture. The darkened urine and lighter stools are found a with conjugated bilirubinaemia, also typical for biliary obstruction.
As the patient is systemically well, what would you proceed to do?
Further imaging with MRCP would be best to investigate the biliary tree.
Unremarkable liver parenchyma. Patent hepatic vasculature.
Marked biliary dilatation, both intra- and extra-hepatic, with common bile duct (CBD) maximally measuring 12 mm.
Thin-walled gallbladder containing multiple calculi. No pericholecystic fluid.
Normal spleen.
No free fluid.