sb/hs
Date : 00.00.00


Name of the Patient : Abc XyzKulshrlmn / M / 24 yrs.
Referred by : Dr. Abc Xyzdeo.Examination : M.R.Cholangiogram.
CLINICAL PROFILE :
C/O pain in abdomen with vomiting since 1-2 years.
Operated for choledochal cyst in November 0000. Papillotomy with stent insertion done in March 0000. Abdominal pain persists.EXAMINATION :
MR Cholangiogram was obtained.
7 mm thick T1 Weighted and T2 Weighted axial images. 5 mm thick T2 Weighted coronal images.
4 mm thick STIR coronal images.
OBSERVATION :
There is still seen a baggy, cystic lesion along the course of the common bile duct which continues distally upto the head of the pancreas and duodenum. This represents a remnant of the choledochal cyst. A fluid level is noted within the remnant cyst. A stent is also noted within the residual cyst.

There is mild dilatation of the right and the left hepatic ducts and the common hepatic duct. There is seen an apparent cut off at the junction of the common hepatic duct with the bowel loop (at the site of the previous hepatico-jejunostomy). No obvious internal filling defects are noted in the hepatic ducts or the residual cyst.

The gall bladder is identified. The pancreatic duct is not dilated.

The liver is normal in size, shape and position. There is no local or diffuse area of altered signal intensity. The intrahepatic venous architecture is normal. ..2/.




Both the visualized kidneys, pancreas, adrenals and spleen are unremarkable.

There is no free fluid in abdomen. There are no abnormally enlarged abdominal lymphnodes noted.

The right sided rectus abdominus muscle is not visualized in part, probably the sequelae of previous surgery.
IMPRESSION :

1. Post-operative status.
2. Residual choledochal cyst along the course of the common bile duct with an internal stent. 3. Mild dilatation of the right and the left hepatic ducts and the common hepatic duct with an apparent cut off at the junction of the common hepatic duct with the bowel loop (at the site of the previous hepatico-jejunostomy). A partial obstruction at the anastomotic site may be considered.

As compared to the previous MRCP dated 00.00.00, there is slight fullness of the right and left hepatic ducts and the common hepatic duct on the present study.