title: Evaluation of recurrent pyogenic cholangitis with CT: analysis of 50 patients.
abstract: The use of computed tomography (CT) was investigated in 50 patients with recurrent pyogenic cholangitis, 22 of whom had undergone prior choledochoenterostomy or sphincteroplasty. A spectrum of pathologic features was noted, including intrahepatic ductal dilatation (n = 50), common duct dilatation (n = 34), strictures (n = 11), intrahepatic calculi (n = 37), common duct calculi (n = 15), pneumobilia (n = 26), segmental atrophy (n = 18), and splenomegaly (n = 7). Unilobar disease existed in 14 patients. The left lateral segment was predominantly affected, with ductal dilatation (n = 23) and segmental atrophy (n = 13). During acute exacerbation, additional manifestations were observed: ductal wall enhancement (n = 4), segmental parenchymal enhancement (n = 9), hepatic abscess (n = 9), and biloma (n = 2). CT enables sensitive, complete evaluation of this disorder. It is valuable when results of ultrasonography are non-diagnostic and for planning hepatic resection, evaluating associated mass lesions, and guiding complex interventional procedures.
authors.affiliation: Diagnostic Radiology Division, University of Hong Kong, Queen Mary Hospital.
authors.forename: F L
authors.initials: FL
authors.lastname: Chan
authors.forename: S W
authors.initials: SW
authors.lastname: Man
authors.forename: L L
authors.initials: LL
authors.lastname: Leong
authors.forename: S T
authors.initials: ST
authors.lastname: Fan
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001653:Bile Ducts, Intrahepatic / Q000000981:diagnostic imaging; D002758:Cholangiography; D002761:Cholangitis / Q000150:complications / Q000000981:diagnostic imaging*; D002769:Cholelithiasis / Q000150:complications / Q000000981:diagnostic imaging; D005260:Female; D006801:Humans; D008099:Liver / Q000000981:diagnostic imaging; D008297:Male; D008875:Middle Aged; D012008:Recurrence; D013492:Suppuration; D014057:Tomography, X-Ray Computed