ARRS Case of the Week

GASTROINTESTINAL IMAGING: Biliary Tree and Gallbladder

Case Author: Meghan Lubner, University of Wisconsin School of Medicine and Public Health

History

47-year-old woman with anemia and right upper quadrant pain.

Imaging Findings

Axial contrast-enhanced CT images show right and left intrahepatic biliary ductal dilatation (straight arrows, A) and multiple low-attenuation lesions (arrowheads, B) in the liver with extrahepatic biliary ductal dilatation, abrupt wall thickening, and transition at the level of the mid duct (circle, B). Axial contrast-enhanced CT image of the pelvis (C) shows a sigmoid mass (star) confirmed at endoscopy with upstream colonic dilatation and fluid-debris level (curved arrow, A and B). ERCP image (D) confirms the high-grade narrowing (circle) in the mid duct correlating with the lesion seen at CT.

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