44 Cystic Dilatation of the Bile Ducts

CLINICAL IMAGAGINGAN ATLAS OF DIFFERENTIAL DAIGNOSIS

EISENBERG

DR. Muhammad Bin Zulfiqar PGR-FCPS III SIMS/SHL

• Fig GI 44-1 Choledochal cyst. Cholangiographic contrast material fills the huge fusiform dilatation of the common bile duct and the markedly dilated intrahepatic ducts.

• Fig GI 44-2 Choledochocele. (A) A well-defined, smooth filling defect (arrow) projects into the duodenal lumen on an upper gastrointestinal series. (B) At cholangiography, the bulbous terminal portion of the common bile duct fills with contrast material and projects into the duodenal lumen (arrow). It is separated from contrast material in the duodenum by a radiolucent membrane.

• Fig GI 44-3 Caroli's disease.

• Fig GI 44-4 Congenital hepatic fibrosis.55

• Fig GI 44-5 Cholangitis. Communicating hepatic abscess simulating localized cystic dilatation of an intrahepatic bile duct.

• Fig GI 44-6 Cholangiohepatitis. A T-tube cholangiogram demonstrates that the common bile duct and intrahepatic duct (lower arrow) are dilated. The upper arrow shows a moderately dilated bile duct with short branches arising at right angles to the duct.56