The patient presented with painless jaundice. He had a past history of Ivor-Lewis oesophagectomy.
There is intrahepatic bile duct dilation. The common bile duct (CBD) is dilated. Within the duct is an echogenic mass filling the lumen. Color Doppler does not show any flow.
The mass does not demonstrate any shadowing (which would suggest choledocholithiasis / stones). ERCP showed a filling defect and cytology revealed adenocarcinoma (?primary, ?secondary). A biliary stent was placed as a palliative procedure.