42 filling defects in the bile ducts

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Transcript of 42 filling defects in the bile ducts

  1. 1. 42Filling Defects in the Bile Ducts
  2. 2. CLINICAL IMAGAGING AN ATLAS OF DIFFERENTIAL DAIGNOSIS EISENBERG DR. Muhammad Bin Zulfiqar PGR-FCPS III SIMS/SHL
  3. 3. Fig GI 42-1 Common bile duct stone (arrow).
  4. 4. Fig GI 42-2 Impacted common bile duct stone (arrow). Characteristic smooth, concave intraluminal filling defect.
  5. 5. Fig GI 42-3 Pseudocalculus. (A) Contrast material encircles the stone-like filling defect (arrow). (B) After relaxation of the sphincter of Oddi, the distal common bile duct appears normal and contrast material flows freely into the duodenum.
  6. 6. Fig GI 42-4 Cholangiocarcinoma presenting as a large filling defect (arrow) in the common bile duct.
  7. 7. Fig GI 42-5 Adenoma. Lobulated sessile mass in the common hepatic duct.53
  8. 8. Fig GI 42-6 Biliary papillomatosis. Multiple polypoid filling defects in dilated intra- and extrahepatic bile ducts (straight arrows). The filling defect in the left hepatic duct (curved arrow) prevents contrast material filing of the left intrahepatic ducts.53
  9. 9. Fig GI 42-7 Liver flukes (Clonorchis sinensis) causing multiple filling defects in the biliary system. Many of the filling defects represent co-existing calculi, which are often seen in this condition.
  10. 10. Fig GI 42-8 Hydatid disease of the liver and biliary tree. Multiple cysts present as filling defects in the bile ducts (black arrows). Note contrast material filling a large communicating cystic cavity in the liver parenchyma (white arrow).