Response letter to “Acute cholangitis: Does malignant biliary obstruction vs choledocholithiasis etiology change the outcomes?” with imaging aspects

Figure 1 Choledochal obstruction caused by calculus. A: Fat-suppressed T2 WI shows calculus (white arrows) in the dilated choledochal duct (circle) and bile sludge (orange arrow). The patient also has autosomal dominant polycystic kidney disease (orange arrows); B: HASTE coronal image shows calculus (white arrow) in the dilated choledochal duct (circle) with smooth borders (curved lines); C: Coronal computed tomography image shows a dilated choledochal duct (circle) with calculus (white arrow) P: Pancreas.

Figure 2 Choledochal involvement of a pancreatic mass. A and B: Coronal T2 WI and coronal magnetic resonance cholangiopancreatography images. The dilated choledochal duct (circle) abruptly narrows bluntly (white arrow) and continues narrowly in a long segment more distally (two-headed arrow). Contour irregularities (serrated lines) are seen on the distal walls of the choledochal duct; C and D: Post-treatment axial and coronal computed tomography images of the same patient show an irregularly bordered, hypodense, heterogeneous, solid mass lesion (circle) in the head of the pancreas, stent material extending from the duodenum to the pancreas (orange arrow), and dilated intrahepatic bile ducts (white arrow).