Gas in biliary tree - CT cholangiography (false postive bile duct strictures)

Case contributed by Dr Chris O'Donnell

Presentation

PH cholecystectomy. Now RUQ pain

Patient Data

Age: 75
Gender: Female

IV Biliscopin infused over 30 minutes prior to scanning.

As in all reconstructed data sets on CT it is very important to review the source images - here the MIP looks like lots of bile duct strictures (sclerosing cholangitis or cholangiocarcinoma) but on the source axial scans, it is clearly due to the presence of gas displacing the contrast agent. Gas has entered the biliary tree via a very large duodenal diverticulum into which the bile ducts enters disturbing the normal ampullary mechanism.

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Case information

rID: 17356
Case created: 6th Apr 2012
Last edited: 7th Oct 2015
Inclusion in quiz mode: Included

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