Atlas of Gastroenterological Endoscopy
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Biliary obstruction by liver metastases from an ovarian cancer
Stents in both ducts
Progressive ovarian cancer. Large lymphomas (abdominal CT scan) obstruct the hepatic fork. Two long plastic stents are inserted into the right and left hepatic bile duct to secure bile flow.
Move the mouse´s arrow onto the picture to colour the stents.
Liver metastases Liver metastases
Concomitantly hepatic metastases are diagnosed. Cholangigraphy reveals irregular ductalar margines with displacement of bile ducts (arrows in the right picture), ductular interruptions and sudden stops of contrast filling (arrows in the left picture).
Metastasized gall bladder carcinoma
A proximal, complete obstruction of the bile duct secondary to cancerous proliferations of a metastasized gall bladder carcinoma is shown. A filiforme stenosis (circle and magnification, above right) causes jaandice. The intrahepatic biliary ducts present very uneven, cor- responding to liver metastases diagnosed sonographically.
Move the mouse´s arrow onto the picture to colour the stenosis.
Stenosis with guide wire Sonographic view of the stent
The stenosis, 3,5 cm in length (x- ray positive ruler) is bridged by a plastic prothesis. Sonographically the stent is imaged as a double outline (ST). The same picture shows multiple intrahepatic metastases.
Additionally a cystic metastase, 11,2 cm in diameter, is found in the left lower quadrant. Liver metastase of an ovarian cancer