Presentation
Obstructive jaundice
Patient Data
The liver of size, shape and tomographic density preserved. Hepatics and portal vein are permeable. The bile duct is observed obliterated by extrinsic compression of the gallbladder, without ruling infiltration. The gallbladder is distended with calcified gallstones therein and a with focal wall thickening, reaching up to 7 mm thick with contrast enhancement in the wall, which shows extrinsic compression of the common bile duct, without preserving cleavage plane, with the head of the pancreas. The rest of the pancreas shows typical enhancement. The intrapancreatic choledochal impressing obliterated by infiltration.
Also observed a thickening of the wall of the transverse colon, asymmetrical concentric with poorly defined with respect to fat. The hepatic flexure of the colon also shows concentric thickening of the wall, which continues throughout the right colon
Case Discussion
This case shows a gallbladder carcinoma associated to cholelithiasis with signs of invasion of the liver parenchyma, bile duct and loss of cleavage plane with the colon. Focal thickening is intermittent, involving the transverse colon, hepatic flexure of colon and right colon, infiltrative appearance, with no direct contact between the gallbladder and the colon wall.
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