Biliary System
Last updated (28 October 2003)
Good Stuff
Spot Diagnosis
Biliary System
Padding space Leaky Bile
Padding space Q1
Padding space Q2
Padding space Q3
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Padding space Q5
Leaky Bile Click on the image to download a larger version
This scan was performed to aid further management of the patient.
What is it?
What does it show?
A HIDA scan
A 3d reconstruction of an ultrasound
A 3d reconstruction of a CT
An magnetic resonance imageing scan
An image from electon microscopy of enterobies vermicularis
Improve your X-Ray reading skills

The answer

This image is a magnetic resonance cholagio-pancreatogram (MRCP). It shows no evidence of a distal obstruction or a defect in the common bile duct. There is a long cystic duct stump and there appears to be a puddle of fluid in contact with the end of the cystic duct stump.

What the student might say

This image is a magnetic resonance cholangio-pancreatogram (MRCP).

It shows a long cystic duct remnant with puddle of fluid associated with the end of the stump, this is probably the site of the leak and corresponds nicely with the laparoscopic image.

Small Print

HIDA scans are nuclear medical scans which examine the biliary system. They usually appear spotty due to the effects of the gamma rays from the administered radio pharmaceutical on the gamma camera. The spots where there is radioactivity are usually seen as black.

This is not a 3d reconstruction from ultrasound or CT. 3d reconstruction from CTs is done particularly in vascular imaging. It would be difficult to get enough contrast in the bile duct to get a nice 3d reconstruction from a CT. If you were going to directly inject contrast into the biliary system then you can usually get nice images with fluroscopy.

No this is not an EM picture of thread worms.

Adrian P. Ireland