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INTRAMURAL CBD COLLATERALS –
MIMICKER OF CHOLANGITIS/
CHOLANGIOCARCINOMA
DR. RUSHABH SHAHDR. RUSHABH SHAH,,
CONSULTANT RAD...
Enhancing thickening of suprapancreatic CBD
with mild narrowing, no obstructive biliopathy
SPLENOMEGALY
PARTIAL PV
THROMBOSIS
MULTIPLE PORTOSYSTEMIC
COLLATERALS
DIAGNOSIS:
•Partial portal venous thrombosis,
•Multiple porto-systemic collaterals
•Splenomegaly
•No active arterial enhan...
DISCUSSION:
•Middle aged woman presented with heaviness in abdomen &
pain, no previous medical or surgical history
•On Ima...
DISCUSSION:
•Middle aged woman presented with heaviness in abdomen &
pain, no previous medical or surgical history
•On Ima...
Intramural collaterals- case report by DR. RUSHABH G SHAH
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Intramural collaterals- case report by DR. RUSHABH G SHAH

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Intramural collaterals- case report by DR. RUSHABH G SHAH

  1. 1. INTRAMURAL CBD COLLATERALS – MIMICKER OF CHOLANGITIS/ CHOLANGIOCARCINOMA DR. RUSHABH SHAHDR. RUSHABH SHAH,, CONSULTANT RADIOLOGISTS,CONSULTANT RADIOLOGISTS, INFOCUS DIAGNOSTICS, AHMEDABAD, GUJARAT.INFOCUS DIAGNOSTICS, AHMEDABAD, GUJARAT.
  2. 2. Enhancing thickening of suprapancreatic CBD with mild narrowing, no obstructive biliopathy
  3. 3. SPLENOMEGALY PARTIAL PV THROMBOSIS MULTIPLE PORTOSYSTEMIC COLLATERALS
  4. 4. DIAGNOSIS: •Partial portal venous thrombosis, •Multiple porto-systemic collaterals •Splenomegaly •No active arterial enhancement of CBD wall thickening •Gradual venous phase filling •Confirmation of intramural collaterals on doppler PORTAL VENOUS THROMBOSIS WITH INTRAMURAL COLLATERALS OF CBD
  5. 5. DISCUSSION: •Middle aged woman presented with heaviness in abdomen & pain, no previous medical or surgical history •On Imaging: Changes of portal hypertension and CBD wall thickening, ? cholangitis ? cholangiocarcinoma •Portal vein thrombosis leads to portal hypertension with development of cavernous transformation (CTPV) and porto- portal collaterals at the hepatic hilum. These collaterals may involve the paracholecystic, para-epicholedochal, and pancreaticoduodenal veins and bypass the obstructed portal vein segment. Portal biliopathy may develop. •Very rarely there is cavernous transformation of veins within the wall of CBD as in our case.
  6. 6. DISCUSSION: •Middle aged woman presented with heaviness in abdomen & pain, no previous medical or surgical history •On Imaging: Changes of portal hypertension and CBD wall thickening, ? cholangitis ? cholangiocarcinoma •Portal vein thrombosis leads to portal hypertension with development of cavernous transformation (CTPV) and porto- portal collaterals at the hepatic hilum. These collaterals may involve the paracholecystic, para-epicholedochal, and pancreaticoduodenal veins and bypass the obstructed portal vein segment. Portal biliopathy may develop. •Very rarely there is cavernous transformation of veins within the wall of CBD as in our case.

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