Primary sclerosing cholangitis.The patient has a history of ulcerative colitis and abnormal liver-function tests. The ERCP shows a rather complex stricture at the upper end of the common hepatic duct with quite marked dilatation of the left hepatic duct and, to a lesser extent, the right hepatic duct above this level. The appearance is indistinguishable from cholangiocarcinoma, but, in this case, an ERCP performed 12 months previously had an identical appearance. (Courtesy of Dr Peter Mills.)
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