May 2007

Abnormal bile ducts in the liver hilum

Clinical Info

Jaundice without pain

Ultrasound Images & Clips

68 year old female, Jaundice without pain

Transverse image of the upper abdomen with an intraductal structure in the bile ducts at the liver hilum
Transverse image of the upper abdomen with an intraductal structure in the bile ducts at the liver hilum
Transverse image of the liver with dilatated intrahepatic bile ducts
Transverse image of the liver with dilatated intrahepatic bile ducts
There is a soft tissue structure at the bifurcation of the bile ducts
There is a soft tissue structure at the bifurcation of the bile ducts
The structure shows vascularity which rules out sludge or hemobilia
The structure shows vascularity which rules out sludge or hemobilia
The gallbladder is small and contracted indicating a high biliary tract obstruction
The gallbladder is small and contracted indicating a high biliary tract obstruction
There are enlarged mesenteric lymphe nodes
There are enlarged mesenteric lymphe nodes
CT scan of the same patient showing dilatated intrahepatic bile ducts. The patient was suspected of having a bile duct carcinoma, in this location also known as Klatskin tumor. The prognosis is poor. The enlarged lymphe nodes are suggestive for metastases. An ERCP was performed.
CT scan of the same patient showing dilatated intrahepatic bile ducts. The patient was suspected of having a bile duct carcinoma, in this location also known as Klatskin tumor. The prognosis is poor. The enlarged lymphe nodes are suggestive for metastases. An ERCP was performed.
The ERCP shows dilatated intrahepatic bile ducts and a non dilatated distal common bile duct
The ERCP shows dilatated intrahepatic bile ducts and a non dilatated distal common bile duct

Conclusion

A brush was performed for pathological confirmation. To releave the jaundice stents were placed in the bile ducts.
Diagnosis Klatskin tumor (cholangiocarcinoma).

References
Bloom CM, Langer B, Wilson SR. Role of US in the detection, characterization, and staging of cholangiocarcinoma.
Radiographics. 1999 Sep-Oct;19(5):1199-218.


Details

  • Sex: Female
  • Age: 68

Created with

  • Hitachi Ultrasound System