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Benign biliary stricture

Nieman CMN - MedPix

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Affiliation: Brooke Army Medical Center

ABSTRACT

Diagnosis: Benign biliary stricture

History: 60 year old male re-presents with painless jaundice several months after undergoing a Whipple procedure for a pancreatic head mass. Denies fever, itching. Wife denies mental status changes. Pathologic analysis of the resected pancreatic head mass had revealed sequelae of chronic pancreatitis.

Findings: Image 1: Percutaneous cholangiography via a lateral approach into the right intrahepatic biliary ducts demonstrating severe long segment stenoses of the proximal right and left intrahepatic biliary ducts which probably included the anstamoses with the choledochojejunostomy. There is early reflux into the proximal left intrahepatic biliary ducts. Image 2: Placement of a 10 French silastic catheter across the long segment stenosis of the right intrahepatic and right biliary duct into the jejunum. Image 3: Catheter repositioned to maximize drainage of both hepatic lobes through the multiple side ports.

Ddx: Possible etiologies for stricture: 1) Sequela of pancreatitis via associated ascending cholangitis. 2) Inflammation related to surgery.

Exam: PE: Icteric sclera. Jaundiced skin. Laboratory: Obstructive hyperbilirubinemia.

No MeSH data available.


Percutaneous cholangiography via a lateral approach into the right intrahepatic biliary ducts demonstrating long segment stenoses in the proximal bilateral intrahepatic biliary ducts after Whipple procedure.
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MPX1597_synpic19332: Percutaneous cholangiography via a lateral approach into the right intrahepatic biliary ducts demonstrating long segment stenoses in the proximal bilateral intrahepatic biliary ducts after Whipple procedure.


Benign biliary stricture

Nieman CMN - MedPix

Percutaneous cholangiography via a lateral approach into the right intrahepatic biliary ducts demonstrating long segment stenoses in the proximal bilateral intrahepatic biliary ducts after Whipple procedure.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=MPX1597&req=5

MPX1597_synpic19332: Percutaneous cholangiography via a lateral approach into the right intrahepatic biliary ducts demonstrating long segment stenoses in the proximal bilateral intrahepatic biliary ducts after Whipple procedure.

View Article: MedPix Image - MedPix Case

Affiliation: Brooke Army Medical Center

ABSTRACT

Diagnosis: Benign biliary stricture

History: 60 year old male re-presents with painless jaundice several months after undergoing a Whipple procedure for a pancreatic head mass. Denies fever, itching. Wife denies mental status changes. Pathologic analysis of the resected pancreatic head mass had revealed sequelae of chronic pancreatitis.

Findings: Image 1: Percutaneous cholangiography via a lateral approach into the right intrahepatic biliary ducts demonstrating severe long segment stenoses of the proximal right and left intrahepatic biliary ducts which probably included the anstamoses with the choledochojejunostomy. There is early reflux into the proximal left intrahepatic biliary ducts. Image 2: Placement of a 10 French silastic catheter across the long segment stenosis of the right intrahepatic and right biliary duct into the jejunum. Image 3: Catheter repositioned to maximize drainage of both hepatic lobes through the multiple side ports.

Ddx: Possible etiologies for stricture: 1) Sequela of pancreatitis via associated ascending cholangitis. 2) Inflammation related to surgery.

Exam: PE: Icteric sclera. Jaundiced skin. Laboratory: Obstructive hyperbilirubinemia.

No MeSH data available.