CT
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.