Ascending cholangitis

Case contributed by Dr Michael P Hartung

Presentation

Abdominal pain and fever.

Patient Data

Gender: Male
CT

Mild dilation of intrahepatic bile ducts. Diffuse thickening and enhancement of the common hepatic and common bile ducts. Some haziness in the fat within the portal hepatis/portocaval regions with mild adenopathy. Cholecystectomy with liver cysts adjacent to the GB fossa. Spinal fusion and stimulator. 

Case Discussion

This patient presented with fever, right upper quadrant pain, and elevated biliary enzymes. This clinical picture fits the imaging findings of ascending cholangitis with increased enhancement of the common bile duct and porta hepatis/portocaval haziness and adenopathy. The lipase was normal. 

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