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Caroli disease and autosomal recessive polycystic kidney disease

Case contributed by: Dr Frank Gaillard

Presentation:

Fever, jaundice and abdominal pain.

Patient Data:

Age: 15
Gender: Female
Race: Caucasian

Multiple small cystic attenuation areas are seen in bilateral kidneys, suggesting ARPKD.

Multiple hypodense cystic areas are seen in right lobe of liver, which appear to be of similar attenuation to few linear dilated intrahepatic biliary radicals. Some of the lesions show a central enhancing focus ("central dot sign"), suggesting Caroli's disease.

Associated findings such as atrophied right lobe, left lobe hypertrophy, massive splenomegaly (due to portal hypertension), are also seen.

Ectatic cystically dilated peripheral intrahepatic biliary radicals are seen, communicating with biliary tree. Common bile duct and main hepatic duct are relatively prominent measuring 8-9 mm, however appear to have smooth regular outline and does not appear ectatic.

Case Discussion:

Caroli disease have association with both ADPKD and ARPKD.

This case shows association of autosomal recessive polycystic kidney disease with Caroli's disease.

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