51, female, Height Weight Proportional. Non smoker non drinker. No injury to the abdominal area. No biliary surgery history. Never had similar problems before. Abdominal Ultrasound in 2007: The common bile duct was 4 mm.
Chief complaint: Abdominal pain in the upper right side for 1 month. The pain sometimes radiates to right back and shoulder. With a little pale-colored stools. No fever, no dark urine, no itching, no Jaundice.
Blood test: All normal. Liver function all normal. No HAV, HBV, HCV. Total bilirubin 0.7 normal. Amylase 52, normal. Whole blood count normal. Kidney function normal.
Abdominal Ultrasound: The common bile duct is dilated measuring 8.7mm. All other normal.
Chest X ray: (-)
MRI Abdomen w/wo contrast (MRCP):
1. There is intrahepatic biliary duct dilatation. The common bile duct is mildly dilated measuring 9 mm in diameter. There is smooth tapered narrowing of the common duct near its insertion in the duodenum. No intraluminal filling defect is seen. The liver, gallbladder and pancreas are all normal. The pancreatic duct is not dilated.
2. The spleen, adrenal glands, kidneys, aorta are normal.
3. No retroperitoneal lymphadenopathy is seen.
4. No abdominal ascites.
5. No marrow signal abnormality is seen.