The patient was a 50 year old lady who had a history of pruritus and liver disease. Viral serology, metabolic profile and autoimmune profiles were normal. Lately she developed recurring jaundice with raised ALP. MRCP showed a distal CBD stricture. On ERCP, intrahepatic channels were poorly outlined on dye injection-the "pruned biliary tree"(red arrow). The CBD showed distal tapering (red arrow). We did a sphincterotomy. That was sufficient to drain the biliary system. The negative shadows in the CBD were only air bubbles (green arrow).
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