Intrahepatic bile ducts stones

Case contributed by Mohammad Taghi Niknejad
Diagnosis almost certain

Presentation

Abdominal pain.

Patient Data

Age: 75 years
Gender: Female
This study is a stack
Coronal
T2_hasteirm
This study is a stack
Axial T1
fat sat
This study is a stack
Axial
T2
This study is a stack
Axial
T2
This study is a stack
Coronal
T2_haste_fs
This study is a stack
Coronal
T2
This study is a stack
Axial
T2
This study is a stack
Axial T2
fat sat
This study is a stack
Axial T1
fat sat
This study is a stack
Axial
T1
This study is a stack
Axial
T1_vibe_fs_tra_post/up
This study is a stack
Axial T1
C+ fat sat
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Info

Extra and intrahepatic bile ducts are dilated, dilatation continues up to distal end of CBD. There is no filling defect in the CBD and its distal portion shows tapering.
At least three, non-enhancing, T2W low signal filling defects are noted within the dilated ducts of the second hepatic segment inferring stones.

Several parapelvic cysts are seen at kidneys.

Case Discussion

Bile duct dilatation with intrahepatic bile duct stones, type IV choledochal cyst and recurrent pyogenic cholangitis should be considered on the differential list.

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