PMC10242113_01
Abdominal enhanced computed tomography images. (A) Arterial phase; (B) portal vein phase. The outline of the liver was irregular, with a non-uniform density, while the intrahepatic and hilar bile ducts were significantly widened; (C) three-dimensional vascular reconstruction of the portal vein system. The portal vein and splenic vein were widened, and multiple tortuous vascular shadows were visible in the lower part of the esophagus and around the fundus of the stomach.
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F1
The intrahepatic and hilar bile ducts were dilated and the upper segment of the common bile duct was not clearly visualized (Figure 1).
Magnetic resonance cholangiopancreatography images and digital subtraction angiography. (A) Axial T2-half-Fourier acquisition single-shot turbo spin-echo (T2-HASTE); (B) Sagittal T2-HASTE. The intrahepatic bile duct was significantly widened, cystic dilatation was visible in the hilar bile duct, and the common bile duct was unclear. (C) Digital subtraction angiography of cholangiography showed anastomotic stenosis (white arrow).
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F2
Magnetic resonance cholangiopancreatography (MRCP) showed dilated bile ducts in the hepatic region with unclear visualization of the common bile duct (Figure 2). Anastomotic stenosis was confirmed in subsequent digital subtraction angiography of cholangiography (Figure 2).
Pathological examination images. (A) Hematoxylin and eosin staining showed severe interfacial inflammation (100x); (B) silver staining showed mild peri-sinusoidal fibrosis (40x); (C) cytokeratin 19 staining showed dilated bile duct (100 x); (D) cytokeratin 7 staining of hepatocytes was positive, indicating chronic cholestasis (200x).
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F3
Therefore, the final pathological diagnosis was chronic mild hepatitis with fibrosis (G3S2) and cholestasis (Figure 3).