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Type:
Educational Exhibit
Keywords:
Tissue characterisation, Ischaemia / Infarction, Calcifications / Calculi, Diagnostic procedure, Ultrasound, MR, CT, Biliary Tract / Gallbladder
Authors:
C. Zhang1, T. Liang1, E. Pang1, A. Harris2; 1Vancouver/CA, 2Vancouver, BC/CA
DOI:
10.1594/ecr2016/C-1542
Conclusion
Intrahepatic biliary duct dilation is a common finding on imaging in patients with a variety of symptoms.
A systematic approach to the dilated bile duct is crucial,
as malignant conditions and diseases requiring urgent management should be considered.
Once excluded,
benign inflammatory conditions should be considered.
A first distinction is between obstructive (stone-based etiologies such as choledocolithiasis or stricture-based entities such as cholangiocarcinoma,
IPMN-B should be considered) and other miscellaneous conditions (such as post-inflammatory or inflammatory disorders) and non-obstructive biliary disorders (Caroli disease,
choledochal or biliary cyst,
recurrent pyogenic cholangitis,
primary sclerosing cholangitis) form the differential diagnosis.
In addition to the presence of dilated bile ducts,
and identifying a potential obstructive cause,
consideration of the location of dilatation (segmental or generalized) and whether communication exists with the biliary tree can provide valuable diagnostic information to highlight those malignant and urgent cases requiring expidicious management.