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RADPILES
CASES
QUIZ
QUESTION-1:
Abnormal LFTs:
Primary biliary sclerosis
Primary sclerosis cholangitis
Cholangiocarcinoma
Correct Answer: Primary sclerosis cholangitis
Multifocal strictures of intra and extrahepatic bile ducts
Lack of intrahepatic dilatation characteristic
Treatment options limited
Endoscopic drainage and balloon dilatation
Percutaneous biliary drainage
Transplantation for hepatic failure, variceal bleeding, acsites
EXTRAHEPATIC BILIARY OBSTRUCTION
Benign lesions: Smooth tapering
Malignant lesions
- Abruptly tapered
- Irregular margins
MALIGNANT BILIARY OBSTRUCTION - LOCATION
Distal CBD – ampullary CA
Mid (to distal)CBD – pancreatic CA, lymphoma
CHD or biliary confluence – gallbladder CA, metastsatic dz: lung, colon, breast, cholangiocarcinoma
HILAR OBSTRUCTION
Cholangiocarcinoma
Gallbladder carcinoma
Mets to porta-hepatis
Post-op stricture
Inflammatory stx – Mirizzi syn.
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Correct Answer Explanation
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