PMC10229863_01
(A) Axial computed tomography pulmonary angiogram on admission. Collection of gas in liver segment 6 (yellow circle). (B) Contrast-enhanced computed tomography of the abdomen 154 min after the first CT scan. Collection of gas in liver segment 6 (yellow circle). Incidental finding of a mass of the right adrenal gland (*).
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F1
Purely by chance, the scan found a small, circumscribed gas collection in liver segment 6 with a diameter of 34 millimeters (Figure 1). It showed marked enlargement of the periportal gas collection in liver segment 6 from 34 to 40 mm in diameter with well-described margins, no fluid collections, and no evidence of abscess formation (Figure 1).
View from caudal to segment 6. Palpable affection marked with monopolar cautery.
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F2
The affected liver tissue presented deliquescent underneath an intact liver capsule (Figure 2).
Papillary diverticulum with intubated papilla dorsally rotated and luminal prolapsed.
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F3
An additional ERCP revealed stenosis of the common bile duct due to a parapapillary diverticulum (Figure 3).
Clinical course with relevant laboratory tests and crucial time points.
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F4
Figure 4 provides an overview of the clinical course with relevant laboratory tests.