title: Common bile duct wall thickening due to intramural varices diagnosed by colour Doppler ultrasound.
abstract: Cases of common bile duct (CBD) wall thickening due to varicose dilation of intramural veins consequential to portal vein thrombosis (PVT) are rare and present a considerable differential diagnostic problem, as they can mimic cholangiocarcinoma. In such cases, colour Doppler ultrasound (CD US) is a very valuable diagnostic method. There are only a few reports in literature on CD US findings of collateral circulation in a thickened CBD wall following PVT. A patient with obstructive jaundice, a tumour of the pancreatic head, CBD wall thickening, and pre-existing PVT is presented. CD US demonstrated collateral circulation of the thrombosed portal vein in the thickened wall of the common bile duct, thus ruling out a mass in the CBD. Obstructive jaundice seldom occurs with choledocal varices. In this patient, the bile duct obstruction was due to the carcinoma of the pancreatic head.
authors.affiliation: Department of Internal Medicine, Division of Gastroenterology, University Hospital Dubrava, Avenija G. Suska 6, 10000 Zagreb, Croatia. ivica.grgurevic@zg.htnet.hr
authors.forename: I
authors.initials: I
authors.lastname: Grgurević
authors.forename: M
authors.initials: M
authors.lastname: Buljevac
authors.forename: M
authors.initials: M
authors.lastname: Kujundzić
authors.forename: M
authors.initials: M
authors.lastname: Vukelić-Marković
authors.forename: D
authors.initials: D
authors.lastname: Kardum
authors.forename: B
authors.initials: B
authors.lastname: Brkljacić
mesh_terms: D003135:Common Bile Duct / Q000098:blood supply* / Q000000981:diagnostic imaging / Q000473:pathology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010190:Pancreatic Neoplasms / Q000000981:diagnostic imaging*; D013927:Thrombosis / Q000000981:diagnostic imaging* / Q000209:etiology; D018615:Ultrasonography, Doppler, Color; D014648:Varicose Veins / Q000000981:diagnostic imaging* / Q000209:etiology