PubMed Health⌕ Search
Home/Archive/PubMed

PubMed · 3321217

Pitfalls in cholangiographic interpretation.

M A Turner·S R Cho·J M Messmer
View original source ↗Export metadata ↓

Abstract

Cholangiography is a well established method of evaluating the biliary tract, and the typical appearances of the more commonly encountered biliary tract disorders have been well described. There are many pitfalls, however, in the interpretation of cholangiograms that become apparent as large numbers of patients are examined. These pitfalls may be secondary to: congenital anatomic alteration, failure to appreciate normal biliary ductal anatomy, technical errors, and interpretative confusion. Awareness of these pitfalls is emphasized to avoid serious cholangiographic misdiagnosis.

Explore related subjects

Bile Duct DiseasesBile Duct NeoplasmsCholangiographyCholelithiasisDiagnostic ErrorsHumansJournal ArticleReview

Keep this discovery

Explore connections, maps & timelines

BibTeXRIS

M A Turner, S R Cho, J M Messmer. 1987. Pitfalls in cholangiographic interpretation.. https://doi.org/10.1148/radiographics.7.6.3321217

Cite the original work for its findings. Save a collection to share your selection of sources.

KEEP EXPLORING

Related citations

PubMed2007

Intrahepatic cystic lesions after hepatic portoenterostomy for biliary atresia with bile lake and dilated bile ducts.

BACKGROUND: Intrahepatic cystic lesions develop after hepatic portoenterostomy in some patients with biliary atresia and have been regarded as an indication of poor prognosis; however, there is confusion about the terminology and concepts of the lesions. We investigated whether the cystic lesions constituted a single entity. PATIENTS AND METHODS: From 1980 to 2005, we encountered 80 patients with biliary atresia. Abdominal ultrasonography disclosed intrahepatic cystic lesions in 20 (25%) patients after hepatic portoenterostomy. The cystic lesions were analyzed morphologically with radiologic imaging studies and histologically in 13 patients who underwent liver transplantation. RESULTS: Fifteen patients had solitary simple cystic lesions, and 5 patients had multiple continuous oval or beaded lesions. Solitary lesions had a fibrotic cyst wall and lacked epithelia. Continuous lesions had a cyst wall covered with biliary epithelia. Thirteen patients with solitary cysts died or required liver transplantation. In 2 patients with continuous lesions, surgical reboring of the porta hepatis could eliminate cystic lesions and jaundice. CONCLUSIONS: Intrahepatic cystic lesions include 2 different conditions. Solitary cysts are retention pseudocysts, which should be referred to as a bile lake, and are associated with poor prognosis. Continuous beaded cysts are dilated bile ducts, which may be reversed. This distinction is important when considering the treatment strategy.

Bile Duct Diseases↗
PubMed2006

Bile duct cyst as precursor to biliary tract cancer.

BACKGROUND: Bile duct cysts (BDC) are rare, of uncertain origin, and occur most often in young females of Asian descent. Increasingly, BDCs are reported in the Western population, often with coexistent biliary tract cancer. METHODS: The PubMed and Medline literature databases were searched for pertinent publications regarding the clinical association and molecular biological development of cancerogenesis in BDC. Reports from the last two decades were emphasized. RESULTS: Cancer is found in 10-30% of adults with BDC. The cancer-risk is low in childhood (<1% in the first decade), and shows a clear increase with age. Cholangiocarcinoma is the most common malignancy in BDC, and represents a 20- to 30-fold risk compared to the general population. The mean age of malignancy in BDC is 32 years (about two decades earlier than in the general population). Type I and type IV cysts show a higher cancer incidence, even after cyst excision. Pathological findings strongly suggest a hyperplasia-dysplasia-carcinoma sequence in carcinogenesis of pancreatico-biliary maljunction (PBM). Reflux of pancreatic enzymes, amylase, bile stasis, and an increased intraductal concentration of bile acids contribute to proliferative activity of bile acids in BDC. While microsatellite instability, k-ras mutations, expression of COX-2 and bcl-2, and increased telomerase activity seem to occur early; involvement of cyclin D1, beta-catenin, DPC-4/Smad4 and p53 appear later in carcinogenesis. CONCLUSION: Increased molecular knowledge substantiates the clinically related cancer-risk in BDC. Surgery remains the golden standard for treatment, relieves patients from associated complications, and interrupts the cancerous potential in BDC.

Bile Duct Diseases↗