Pseudo-stricture of the extrahepatic bile duct due to pulsatile hepatic artery artefact
Diagnosis certain
Presentation
Right upper quadrant pain and elevated liver enzymes.
Patient Data
Age: 55 years
Gender: Female
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A focal signal loss is noted in the common hepatic duct just above the cystic duct insertion due to compression by the right hepatic artery miming focal stricture or filling defect. The intrahepatic bile ducts are not dilated. The gallbladder and pancreatic ducts also appeared normal.
Case Discussion
In MRCP, artefactual narrowing and pseudo-stricture of the extrahepatic bile duct can be caused by pulsatile vascular compression of the hepatic and gastroduodenal arteries, and it should not be misdiagnosed as a bile duct stricture, tumor or stone.
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