Portal cavernoma cholangiopathy: an endoscopic ultrasound based imaging approach

Journal of Clinical and Experimental Hepatology
Malay Sharma, Chittapuram S Rameshbabu

Abstract

In patients with portal cavernoma cholangiopathy (PCC), appearance and location of collateral channels depends on extent and location of occlusive thrombus in the porto-mesenteric venous system. If the porto-mesenteric venous system is occluded near the formation of portal vein, blood tends to flow through collateral channels that form varices in and around the common bile duct. Though endoscopic ultrasound (EUS) is considered the investigative modality of choice for evaluating common bile duct obstruction, its role in evaluating collateral pathways in and around the common bile duct is poorly defined. This article reviews the anatomy, genesis and appearance of these collateral pathways in PCC. EUS identifies different layers of the common bile duct (CBD) wall and, in PCC, where varices are in close contact with or part of these different layers, can establish the relationship between them. Thus, EUS appears to be the investigation of choice for tracing the origin and course of collaterals in PCC. Careful study of varices in the common bile duct wall prior to ERCP for bile duct stones or biliary strictures may help to plan the procedure and to manage anticipated complications such as hemobilia.

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Citations

Mar 11, 2015·Journal of Clinical and Experimental Hepatology·Radha K DhimanJang B Dilawari
May 25, 2018·AJR. American Journal of Roentgenology·Reena C JhaAmit Dinesh Kalaria
Jul 1, 2016·World Journal of Radiology·Sudheer S PargewarAmar Mukund
Oct 7, 2017·Abdominal Radiology·Susana G RodriguesAnnalisa Berzigotti
Sep 28, 2018·Journal of Hepato-biliary-pancreatic Sciences·Moinak Sen SarmaUjjal Poddar
Jun 24, 2017·Journal of Clinical Gastroenterology·Scott CathcartMicheal Schuster
Apr 26, 2021·Clinical Journal of Gastroenterology·Cosmas Rinaldi Adithya Lesmana, Baiq Kirana Dyah Mandasari

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Cavernous Hemangioma

Cavernous hemangioma is a blood vessel defect or benign tumor that leads to leakage of blood to the surrounding tissues. This can occur in several organs including the brain, which can lead to seizures. Discover the latest research on cavernous hemangiomas here.

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