Tuesday, September 24, 2013

Carcinoma of pancreatic head causing obstructive jaundice

A 52 year old gentleman with jaundice secondary to a tumor of the pancreas (remember Courvoisier's law). The CT findings were of a dilated gallbladder (A: green arrow) and dilated CBD and pancreatic ducts (A: yellow arrow-the "double duct sign") with a pancreatic mass (A: red arrow). On ERCP,  contrast injection outlined a markedly dilated CBD and intrahepatic channels (B1 & B2: green arrows) with a sharp cutoff point near the level of cystic duct. A plastic 10F x10 cm stent was placed (C: red arrows)

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Second (actually 3rd) ERCP for post transplant biliary leak

This 60 year old gentleman had earlier undergone ERCP and stenting for an anastomotic biliary leakage a few months earlier http://ercp365.bl...