Oriental cholangiohepatitis


35 year old Chinese female presented with 4 days of RUQ abdominal pain, nausea, and chills . She was found to be septic with bandemia - 35%. The patient has a history of cholangitis.

The CT revealed intrahepatic biliary duct dilation out of proportion to the common biliary duct dilatation. There were several hyperdense intra-hepatic biliary calculi, multiple strictures which caused focally dilated ducts shaped like an "arrowhead", and pneumobilia. ERCP demonstrated similar findings and evidence of frank pus.

The clinical history and imaging findings are consistent with oriental cholangiohepatitis, also known as recurrent pyogenic cholangitis.