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The image is a photograph of a page from a medical textbook or study guide, featuring an X-ray image and accompanying text. The X-ray appears to be a cholangiogram, showing the biliary system. The text describes a patient with jaundice and an unsuccessful ERCP, with an alternative investigation performed. The X-ray image is labeled "Figure 4" and has an "RT" marker, indicating the right side.

Below the X-ray, there is a question asking about the investigation performed and any positive findings, as well as a request for differential diagnoses. Handwritten answers are visible, including "Percutaneous Transhepatic Cholangiography" as the type of investigation. Further down, there are some listed answers or potential diagnoses, such as "Dilated Intrahepatic and part of extrahepatic biliary passages" and "BD stticture, cholangiocarcinoma."

The location of Mansehra, Pakistan, is not mentioned or suggested by any element within the image. The image is a purely medical context.
FM-xxDv52

Jun 17, 2026

Mansehra, Pakistan

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The image is a photograph of a page from a medical textbook or study guide, featuring an X-ray image and accompanying text. The X-ray appears to be a cholangiogram, showing the biliary system. The text describes a patient with jaundice and an unsuccessful ERCP, with an alternative investigation performed. The X-ray image is labeled "Figure 4" and has an "RT" marker, indicating the right side. Below the X-ray, there is a question asking about the investigation performed and any positive findings, as well as a request for differential diagnoses. Handwritten answers are visible, including "Percutaneous Transhepatic Cholangiography" as the type of investigation. Further down, there are some listed answers or potential diagnoses, such as "Dilated Intrahepatic and part of extrahepatic biliary passages" and "BD stticture, cholangiocarcinoma." The location of Mansehra, Pakistan, is not mentioned or suggested by any element within the image. The image is a purely medical context.

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FM-xxDv52

Jun 17, 2026

Mansehra, Pakistan

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