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HPB Surgery
Volume 3, Issue 2, Pages 129-137
http://dx.doi.org/10.1155/1991/23701
Case Report

Hepatolithiasis Associated With Anomalous Biliary Anatomy and a Vascular Compression Hepatolithiasis and Anomalous Anatomy

1Hepatobiliary and Liver Transplantation Unit, Royal Free Hospital and School of Medicine, London, UK
2Department of Surgery, Royal Free Hospital, Pond Street, London NW3 2QG, UK

Received 13 June 1990; Accepted 17 June 1990

Copyright © 1991 Hindawi Publishing Corporation. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Biliary tract abnormalities occur in about one of every three people, usually being minor and of no clinical significance.Major abnormalities, however, may present in an unusual manner and provide a major hazard to the unsuspecting surgeon.

A patient presenting with cholangitis without jaundice or abnormal liver function tests is reported. Endoscopic retrograde cholangiography failed to demonstrate any bile ducts in the right postero-lateral segments of the liver, the “naked segment sign”. A percutaneous transhepatic cholangiogram demonstrated a stricture obstructing the right posterior segmental hepatic duct with hepatolithiasis above the stricture. At operation an anomalous vessel was found at the site of the stricture.

This case highlights the unusual way in which biliary tract anomalies may present and the importance of adequate pre-operative investigation.