Case of the Month

July 2005

Patient Data: 68 year old male

Clinical Info: Cholestasis with raised liver enzymes

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Longitudinal image of the bile ducts filled with reflective structures.

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There are no gallstones in the gallbladder.

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The common bile duct is only slightly dilatated.

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The intrahepatic bile ducts are slightly dilatated.

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An ERCP shows filling defects which proved to be bloodclots. The bloodclots cause a moderate bile duct obstruction. The patient had hemobilia. Hemobilia can have several causes such as trauma or tumors. In this case no cause for the hemobilia was found and the hemobilia stopped spontaneously. Hemobilia must be differentiated from other lesions that cause reflective structures in the bile ducts such as sludge, bile duct stones and tumor.

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This image shows reflective material in the common bile duct caused by thickened bile.

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This image shows a reflective structure in the bile duct that proved to be a bile duct carcinoma.

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This image shows a dilatated bile duct with bile duct stones.

For more images of bile duct pathology see:

1.2.19 Bile duct: Various causes of bile duct dilatation