42 Filling Defects in the Bile Ducts

CLINICAL IMAGAGINGAN ATLAS OF DIFFERENTIAL DAIGNOSIS

EISENBERG

DR. Muhammad Bin Zulfiqar PGR-FCPS III SIMS/SHL

• Fig GI 42-1 Common bile duct stone (arrow).

• Fig GI 42-2 Impacted common bile duct stone (arrow). Characteristic smooth, concave intraluminal filling defect.

• Fig GI 42-3 Pseudocalculus. (A) Contrast material encircles the stone-like filling defect (arrow). (B) After relaxation of the sphincter of Oddi, the distal common bile duct appears normal and contrast material flows freely into the duodenum.

• Fig GI 42-4 Cholangiocarcinoma presenting as a large filling defect (arrow) in the common bile duct.

• Fig GI 42-5 Adenoma. Lobulated sessile mass in the common hepatic duct.53

• Fig GI 42-6 Biliary papillomatosis. Multiple polypoid filling defects in dilated intra- and extrahepatic bile ducts (straight arrows). The filling defect in the left hepatic duct (curved arrow) prevents contrast material filing of the left intrahepatic ducts.53

• Fig GI 42-7 Liver flukes (Clonorchis sinensis) causing multiple filling defects in the biliary system. Many of the filling defects represent co-existing calculi, which are often seen in this condition.

• Fig GI 42-8 Hydatid disease of the liver and biliary tree. Multiple cysts present as filling defects in the bile ducts (black arrows). Note contrast material filling a large communicating cystic cavity in the liver parenchyma (white arrow).