RT Journal
A1 Ball CG, House MG, Lillemoe KD
T1 IMage of the month—quiz case
JF Archives of Surgery
JO Archives of Surgery
YR 2011
FD August 1
VO 146
IS 8
SP 989
OP 989
DO 10.1001/archsurg.2011.182-a
UL http://dx.doi.org/10.1001/archsurg.2011.182-a
AB 
A 27-year-old woman was referred to our center with a 13-month history of persistent abdominal pain in the right upper quadrant without jaundice following a laparoscopic cholecystectomy for cholelithiasis. Endoscopic retrograde cholangiopancreatography failed to opacify her left hepatic ducts and demonstrated a paucity of right intrahepatic ducts. Concurrent cross-sectional imaging noted dilated left intrahepatic ducts and significant left hemiliver atrophy. Both percutaneous transhepatic cholangiography (Figure 1) and magnetic resonance cholangiography (Figure 2) revealed complete occlusion of the common hepatic duct at the site of metal clips.