PMC3964669_01
Tubogram through the drain in the left hepatic lobe abscess demonstrating contrast delineating branches of portal vein, second part of duodenum and the pancreatic duct
rcse9501-e8-01.jpg
PMC3964669_01_rcse9501-e8-01.jpg
fig1
A tubogram through the liver drain showed the residual liver abscess cavity communicating with the first part of duodenum with concomitant pancreatography and portal venography (Fig 1).
Angiography demonstrating the drain tube abutting the branches of the portal vein and a thrombus in the portal vein branch
rcse9501-e8-02.jpg
PMC3964669_01_rcse9501-e8-02.jpg
fig2
Conventional angiography through the superior mesenteric artery (portal venous phase) showed the drain to be abutting and possibly compromising the branches of the portal vein with a partial occluding thrombus in the left portal vein (Fig 2).
Endoscopic retrograde cholangiopancreatography demonstrating pancreatic duct stricture and multiple filling defects (possibly stones)
rcse9501-e8-03.jpg
PMC3964669_01_rcse9501-e8-03.jpg
fig3
Once he had stabilised, endoscopic retrograde cholangiopancreatography (ERCP) demonstrated an irregularly dilated duct in the body and tail of the pancreas with multiple filling defects and a possible small segment stricture in the head of the pancreas (Fig 3).