14/02/2026
MRCP Case – Parasites in the Biliary Tree
🧑⚕️ Clinical Data:
-Female patient in her 60s presenting with abdominal pain associated with fever and change in color of the urine and stool.
-Previous PAUS 1 week before showed: IHBRD, Calcular GB and dilated CBD with intraluminal echogenic content.
-Labs: Elevated total bilirubin (4.8 mg/dL) and direct bilirubin (4 mg/dL) with indirect bilirubin being in normal values.
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MRCP Findings:
• Dilated caliber of the Common Hepatic Duct “CHD” and Common Bile Duct “CBD” along their whole length reaching maximum caliber of (23 mm) showing tubular serpiginous filling defects/structures with whorly appearance eliciting predominantly intermediate T2 signal with abrupt caliber change of the distal CBD.
• Subsequent bilobar, communicating central rather than peripheral intra-hepatic biliary radicles dilatation, reaching about 10 mm on the right hepatic duct and 7 mm on the left.
• Notable peri-ampullary circumferential mural thickening, measuring about 1.3 cm, showing diffusion restriction.
• Gall bladder is seen distended with intermediate T2 signal material showing fluid/fluid level representing mud with few calcular filling defects, the smallest measuring about 7 mm.
• Normal caliber of the pancreatic duct.
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📌 Impression:
• CHD and CBD showing intra-luminal filling defects suspicious of parasites.
• Periampullary mural thickening as above detailed with dilated CBD and abrupt lower end and subsequent IHBBRs dilatation.
• Calcular muddy GB.
Rest of the study shows:
o Hepatomegaly with beaver’s tail variant and right renal cyst.
