Case list for Recurrent Pyogenic Cholangitis (RPC)
There are 2 CT cases with this diagnosis.
Portal venous phase CT shows significant bile duct dilatation of both lobes due to recurrent pyogenic cholangitis with hepatolithiasis. Calculi are not radioopaque, which makes their detection and therefore the correct diagnosis difficult. Compare to MR, where the calculi are much better shown.
Note hypervascular perfusion anomaly (THAD) of the left lobe on the first image, which is due to the massive bile duct dilatation.
CT show classic signs of recurrent pyogenic cholangitis: hyperdense hepatolithiasis of the left biliary system and steatosis of the unaffected right hepatic lobe on unenhanced exam. Moderate chronic bile duct dilatation on the left causing chronic inflammation and fibrosis of the left lobe.