Recurrent Pyogenic Cholangitis: Angiographic Findings and Its Significance

Kim, Young Chan; Kim, Eui Jong; Oh, Joo Hyung; Yoon, Yup; Lim, Joo Won; Kim, Ihn Sub

Abstract

PURPOSE
To analyse the angiographic findings of recurrent pyogenic cholangitis.
MATERIALS AND METHODS
Hepatic arteriography and portography were performed preoperatively in 34 patients with intrahepatic stones and recurrent cholangitis. Twenty five of these underwent partial resection of the liver and in nine, the biliary tract was drained. Hepatic arteriogram and portogram findings correlated with liver atrophy and were analysed retrospectively by two radiologists; angiographic and pathologic findings also correlated.
RESULTS
In the arterial phase, abnormal stained areas, were seen in 17 of 34 cases, periarterial staining in 14, mass-like staining in two and a mixed pattern in one. The hepatic artery showed spastic change in 11 of 34 cases and tortuous change in 17. Arteriovenous shunting was not seen. In the portal phase, abnormal findings of the portal veins were noted in 16 cases; decreased size and nonvisualization were seen in eleven patients, and decreased size only, in five. Fifteen cases showed liver atrophy; in 13 of these, portal vein abnormalities were also present.
CONCLUSION
In recurrent pyogenic cholangitis, angiographic findings may be normal or findings of abnormal periarterial staining, mass-like staining, spastic and tortuous change of the hepatic artery, and abnormal portal vein can be present. The differential diagnosis of hepatitis, hepatic mass and cirrhosis should be considered.