case_images: PMC10294125_01
case_images: Magnetic resonance cholangiography showing dilatation of the choledocus, intrahepatic, and common bile ducts.
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case_images: F1
case_images: Liver enzymes remained elevated at the following laboratory blood tests; therefore, the patient underwent further investigations with magnetic resonance cholangiography that revealed dilatation of the choledocus, intrahepatic, and common bile ducts, which smoothly entered into the duodenum, with no distinct signs of malignancy (Fig. 1).
case_images: EUS showing a structure of the second portion of the duodenum (a) with erythematous mucosa (b) and protrusion of the ampulla of Vater (c).
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case_images: F2
case_images: After multidisciplinary team evaluation, an endoscopic ultrasonography (EUS) was performed showing a stricture of the second portion of the duodenum with erythematous mucosa and protrusion of the ampulla of Vater (Fig. 2).
case_images: EUS showing dilatation of main pancreatic duct (a) with preserved pancreatic parenchyma (b).
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case_images: F3
case_images: Additionally, a dilatation of the main pancreatic duct in all of its portions was described (Fig. 3a), with preserved pancreatic parenchyma (Fig. 3b).