Intramural collaterals- case report by DR. RUSHABH G SHAH
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Transcript of Intramural collaterals- case report by DR. RUSHABH G SHAH
INTRAMURAL CBD COLLATERALS – MIMICKER OF CHOLANGITIS/ CHOLANGIOCARCINOMA
DR. RUSHABH SHAHDR. RUSHABH SHAH, ,
CONSULTANT RADIOLOGISTS,CONSULTANT RADIOLOGISTS,
INFOCUS DIAGNOSTICS, AHMEDABAD, GUJARAT. INFOCUS DIAGNOSTICS, AHMEDABAD, GUJARAT.
Enhancing thickening of suprapancreatic CBD with mild narrowing, no obstructive biliopathy
SPLENOMEGALY
PARTIAL PV THROMBOSIS
MULTIPLE PORTOSYSTEMIC COLLATERALS
DIAGNOSIS:•Partial portal venous thrombosis,•Multiple porto-systemic collaterals•Splenomegaly
•No active arterial enhancement of CBD wall thickening•Gradual venous phase filling•Confirmation of intramural collaterals on doppler
PORTAL VENOUS THROMBOSIS WITH INTRAMURAL COLLATERALS OF CBD
DISCUSSION:•Middle aged woman presented with heaviness in abdomen & pain, no previous medical or surgical history
•On Imaging: Changes of portal hypertension and CBD wall thickening, ? cholangitis ? cholangiocarcinoma
•Portal vein thrombosis leads to portal hypertension with development of cavernous transformation (CTPV) and porto-portal collaterals at the hepatic hilum. These collaterals may involve the paracholecystic, para-epicholedochal, and pancreaticoduodenal veins and bypass the obstructed portal vein segment. Portal biliopathy may develop.
•Very rarely there is cavernous transformation of veins within the wall of CBD as in our case.