Department of Radiology, Haeundae Paik Hospital, Inje University, College of Medicine, Busan, Korea
ABSTRACT
Biliary stones associated disease has different manifestation with East and West, mainly reported in far Eastern Asian population and are not frequently encountered in the West, but this disease is now being seen more frequently in Western country, result of increased immigration from Asian countries. Bile infection seems to play an important role in the pathogenesis of intrahepatic stones; the calculi are usually brown, bilirubin-pigmented, and friable. Classification of cholangitis associated with biliary stones disease are acute cholangitis, sclerosing cholangitis, and recurrent pyogenic cholangitis. Recurrent pyogenic cholangitis is characterized clinically by recurrent attachs of fever, chills, abdominal pain, and jaundice caused by intrahepatic ductal strictures and pigment stones. The CT features of recurrent pyogenic cholangitis include bile stricture with dilatation, biliary calculi, hepatic atrophy, portal vein obliteration, hepatic abscess and biloma. These findings may obscure and lead to delayed diagnosis of cholangiocarcinoma associated with recurrent pyogenic cholangitis. In this lecture, we will discuss the radiologic findings focus on Ultrsonography, multidetector CT, MR cholangiopancreatography of biliary stones associated disease, recurrent pyogenic cholangitis, and their main causes; parasitic diseases of the biliary tract including Clonorchiasis, Ascariasis.
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