Left lobe atrophy due to biliary obstruction

Case contributed by Dr Brendon Friesen

Presentation

Recurrent right upper quadrant pain. Lap chole 3yrs prior.

Patient Data

Age: 80
Gender: Male
Modality: CT

Atrophy of the left lobe of liver with moderate left intrahepatic biliary dilatation. The main and left portal veins are patent.

Compensatory hypertrophy of the right lobe. The caudate lobe is normal.
Contour step between atrophied left and hypertrophied right lobes anteriorly.

No dilatation of right intrahepatic ducts or common duct or pancreatic duct.

Cholecystectomy clips.

Modality: MRI

MRCP demonstrating moderate left intrahepatic ductal dilatation, with apparent short segment stricturing of left main hepatic duct, not involving the confluence. The right intrahepatic ducts and common duct are normal calibre. No common duct stricture or filling defect.

Case Discussion

Left lobe liver atrophy due to biliary obstruction, which may be benign (post-cholecystectomy biliary stricture) or malignant (cholangiocarcinoma).

No histology available for this case.

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Case Information

rID: 38173
Case created: 9th Jul 2015
Last edited: 14th Nov 2016
Inclusion in quiz mode: Included

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