Imaging misdiagnosis and clinical analysis of significant hepatic atrophy after bilioenteric anastomosis: A case report

Figure 1 This patient underwent abdominal plain computed tomography and contrast enhanced scanning. A: Abdominal computed tomography (CT) revealed the liver was significantly deformed and the spleen was enlarged; Orange arrows indicate dilated bile ducts and high-density stones in the liver; B: Contrast-enhanced CT images showed obvious dilatation of intrahepatic bile ducts; C: CT image showed small intestinal imaging around the liver, suggesting the possibility of bilioenteric anastomosis, as indicated by the orange arrow; D: Contrast-enhanced CT images showed the portal vein and hepatic vein in the liver, the portal vein had been significantly displaced, and the hepatic vein was significantly narrowed and smaller.

Figure 2 Abdominal computed tomography image. A: Multiple stones in the intrahepatic bile duct; B: The hepatic veins draining back into the inferior vena cava were narrowed; C: The main portal vein runs through the middle of the liver lobe; D: Magnetic resonance cholangiopancreatography showed dilatation of intrahepatic bile ducts, indicated by the orange arrow and did not show bilioenteric anastomosis.

Figure 3 Intraoperative and postoperative images. A: Obvious atrophy and thinning of the left and right liver lobes were observed during the operation; B: After resection of the left and right liver lobes, the caudate lobe of the liver with huge hyperplasia was shown, as indicated by the green arrows; C: Left and right liver specimens; D: The arrow indicates percutaneous transhepatic placement of a drainage tube into the dilated intrahepatic bile duct; E: The tip of the drainage tube was inserted into the abdominal cavity, as indicated by the arrow, a small amount of fluid was collected in the abdominal cavity; F: Atelectasis of both lower lobes accompanied by pleural effusion.