CT SCAN OF ABDOMEN

Plain sections were obtained through the liver after opacifying the bowel loops
with oral contrast.
This was followed by a dynamic helical CT study through the abdomen.
Liver is enlarged and shows dilated intrahepatic biliary ducts and dilated common
bile duct (12.8mms)
There is a heterogenously enhancing mass arising from the gall baldder fossa with
intrahepatic extension.
Lesion is mainly cystic with enhancing soft tissue areas within.
Intrahepatic extendion is at segments 4a,4b and 5.
Mass measures 7.8 x 4.41cm
Gall bladder is not visualised seperate from the mass.
CBD measures 12.8mm
No obvious pancreatic lesion is seen.
There is no ascites.
Spleen is normal.
Urinary bladder is distended and Normal.
The uterus is compatible with patients age and shows endometrial fluid distension.
Visualized portion of contrast filled bowel loops appears normal.
Major abdominal vessels including IVC and aorta appear normal.
No lymphadenopathy seen.
Spine shows degenerative changes.
IMPRESSION:
EXTRAHEPATIC BILIOPATHY.
CT FINDINGS SUGGEST Ca.GALL BLADDER WITH INTRAHEPATIC EXTENSION.
FOR HISTOPATHOLOGICAL CORRELATION.
The liver is enlarged with moderate dilatation of the intrahepatic ducts.
However, no focal or diffuse area of altered attenuation is seen.
The gall bladder is distended with thicfkened walls in the fundal region and
ntraluminal hyperdensity.
The common bile duct is is also markedly dilated and tortous.It measures 13 mm
mass seen involving the head of pancreas with irregular margins and peripheral
irregularity.
Mass measures 3.3cm in AP dimension.
Rest of the pancreas is normal in size and irregular in shape with focal areas of
decreased attenuation.
There is also peripancreatic stranding and hypodensity ?
fluid collection.
The spleen and both adrenals are normal.
Stomach,duodenum and bowel loops are within normal limits
Both kidneys are normal in size and shape. They excrete contrast promptly.
No focal area of altered attenuation or mass lesion is detected.
The abdominal mesentery and vasculature is normal.
Uterus and adnexa shows no abnormality.

CONCLUSION: - EXTRAHEPATIC BILIARY OBSTRUCTION from a pancreatic lesion.

-suggestive of a Ca.Head of pancreas.
Correlate with clinical and laboratory signs.

DR.MOBOLAJI A.IYUN
MBBS,FWACS
RADIOLOGIST