clinical history: elderly woman presented with severe jaundice and change
in the color of her stool.
![]()
![]()
![]()
![]()
![]()
findings: three ct images are provided over the upper abdomen.
the first scan shows the dilatation of the intrahepatic biliary system
and a fluid mass in the left lobe of the liver.
the second scan shows the dilatated common duct continuing toward the pancreas.
the proximal nect of the gallbladder is seen in the porta hepatis.
the third scan shows a dilated gallbladder and a normal appearing common duct.
ercp shows opacification of the common duct and the pancreatic duct,
with focal narrowing in both.
diagnosis: operable pancreatic neoplasm. infiltrating neoplasm involving the common bile duct and pancreatic duct. simple hepatic cyst.
discussion: dilatation of the ductal system can be appreciated by noting the low density branching structure within the liver, which converges in the porta hepatis to form the common bile duct. the common bile duct dilatation ends in the porta, above the head of the pancreas indicating that the problem is confined to the duct. the abrupt ending infers neoplasm because inflammation typically shows sequentially smaller concentric rings as the duct tapers distally. ercp shows narrowing of the common duct and pancreatic duct. concurrent narrowing of both makes infiltrating neoplasm most likely. ct scan indicates the patient is opearable, but an angiogram was performed to document operability because of the anticipated whipple procedure.
[本贴已被 翁志蓬 于 2004-4-21 23:33:12 修改过]
[本贴已被 翁志蓬 于 2004-4-22 0:04:04 修改过]
[本贴已被 翁志蓬 于 2005-10-9 1:35:09 修改过] | 
发表于 2004-4-21 03:27
QQ好友和群
QQ空间
腾讯微博
腾讯朋友
收藏
赞同
反对
楼主