Bile duct stricture
This 53-year old woman underwent a cholecystectomy in 1977 and was found to have a bile duct stricture with a grossly dilated bile duct. She was given a diagnosis of Caroli's disease. During the subsequent 10 years she had numerous episodes of cholangitis with fever and leukocytosis, which responded to antibiotics. When she was evaluated in 1985, a CT scan showed a massively dilated common bile duct (6-cm) and an ERCP confirmed the diagnosis of choledocholithiasis with massive dilatation of the extra and intrahepatic bile ducts. In view of the intrahepatic bile ducts it was appreciated how the prior diagnosis of Caroli's disease might have been made. The key point here is to exclude extrahepatic obstruction in all cases of this type.
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