case_images: PMC6354675_01
case_images: Pancreatic CT scan. General dilatation of the intrahepatic biliary tree and terminal common bile duct.
case_images: rjy340f01.jpg
case_images: PMC6354675_01_rjy340f01.jpg
case_images: rjy340F1
case_images: CT scan was performed to discard a neoplastic obstruction and confirmed an intrahepatic biliary ductal dilatation (Fig. 1) and a dilatation of the distal bile duct with no luminal lesions (Fig. 2).
case_images: ERCP. Heterogeneous pancreatic parenchyma and pseudonodular appearance of the pancreatic head. Wirsung duct with no stenosis or obstructions. Common bile duct with normal caliber until the intrapancreatic portion where a highly suspicious of malignancy 2 cm irregular stenosis is seen.
case_images: rjy340f03.jpg
case_images: PMC6354675_01_rjy340f03.jpg
case_images: rjy340F3
case_images: The MRCP, on the other hand, suggested the existence of a distal cholangiocarcinoma, because of the sudden typical stenosis in the distal CBD with a general dilatation of the upper bile ducts (Fig. 3).