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Digestive Disease Interventions 2017; 01(01): 003-007
DOI: 10.1055/s-0037-1599798
Review Article
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Imaging of Biliary Infections

Onofrio Catalano
1   Division of Abdominal Imaging, Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts
,
Ronald S. Arellano
2   Division of Interventional Radiology, Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts
› Author Affiliations
Further Information

Publication History

12 November 2016

30 January 2017

Publication Date:
17 March 2017 (online)

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Abstract

Biliary tract infections cover a wide spectrum of etiologies and clinical presentations. Imaging plays an important role in understanding the etiology and as well as the extent of disease. Imaging also plays a vital role in assessing treatment response once a diagnosis is established. This article will review the imaging findings of commonly encountered biliary tract infectious diseases.

Keywords

biliary infections - cholangitides - parasites - immunocompromised - echinococcal
 

  • References

  • 1 Kimura Y, Takada T, Kawarada Y , et al. Definitions, pathophysiology, and epidemiology of acute cholangitis and cholecystitis: Tokyo guidelines. J Hepatobiliary Pancreat Surg 2007; 14 (1) 15-26
    CrossrefPubMedGoogle Scholar
  • 2 Lee CC, Chang IJ, Lai YC, Chen SY, Chen SC. Epidemiology and prognostic determinants of patients with bacteremic cholecystitis or cholangitis. Am J Gastroenterol 2007; 102 (3) 563-569
    CrossrefPubMedGoogle Scholar
  • 3 Sung JY, Costerton JW, Shaffer EA. Defense system in the biliary tract against bacterial infection. Dig Dis Sci 1992; 37 (5) 689-696
    CrossrefPubMedGoogle Scholar
  • 4 Carpenter HA. Bacterial and parasitic cholangitis. Mayo Clin Proc 1998; 73 (5) 473-478
    CrossrefPubMedGoogle Scholar
  • 5 Hanau LH, Steigbigel NH. Acute (ascending) cholangitis. Infect Dis Clin North Am 2000; 14 (3) 521-546
    CrossrefPubMedGoogle Scholar
  • 6 Tabata M, Nakayama F. Bacteriology of hepatolithiasis. Prog Clin Biol Res 1984; 152: 163-174
    PubMedGoogle Scholar
  • 7 Navaneethan U, Jayanthi V, Mohan P. Pathogenesis of cholangitis in obstructive jaundice-revisited. Minerva Gastroenterol Dietol 2011; 57 (1) 97-104
    PubMedGoogle Scholar
  • 8 Csendes A, Hurdiles P, Diaz JC, Maluenda F, Ferrario M, Compan A. Bacteriological studies of liver parenchyma in controls and in patients with gallstones or common bile duct stones with or without acute cholangitis. Hepatogastroenterology 1995; 42 (6) 821-826
    PubMedGoogle Scholar
  • 9 Bader TR, Braga L, Beavers KL, Semelka RC. MR imaging findings of infectious cholangitis. Magn Reson Imaging 2001; 19 (6) 781-788
    CrossrefPubMedGoogle Scholar
  • 10 Karki S, Joshi KS, Regmi S, Gurung RB, Malla B. Role of ultrasound as compared with ERCP in patient with obstructive jaundice. Kathmandu Univ Med J (KUMJ) 2013; 11 (43) 237-240
    PubMedGoogle Scholar
  • 11 Arai K, Kawai K, Kohda W, Tatsu H, Matsui O, Nakahama T. Dynamic CT of acute cholangitis: early inhomogeneous enhancement of the liver. AJR Am J Roentgenol 2003; 181 (1) 115-118
    CrossrefPubMedGoogle Scholar
  • 12 Lardière-Deguelte S, Ragot E, Amroun K , et al. Hepatic abscess: diagnosis and management. J Visc Surg 2015; 152 (4) 231-243
    CrossrefPubMedGoogle Scholar
  • 13 Patel NB, Oto A, Thomas S. Multidetector CT of emergent biliary pathologic conditions. Radiographics 2013; 33 (7) 1867-1888
    CrossrefPubMedGoogle Scholar
  • 14 Kondo S, Isayama H, Akahane M , et al. Detection of common bile duct stones: comparison between endoscopic ultrasonography, magnetic resonance cholangiography, and helical-computed-tomographic cholangiography. Eur J Radiol 2005; 54 (2) 271-275
    CrossrefPubMedGoogle Scholar
  • 15 Håkansson K, Ekberg O, Håkansson HO, Leander P. MR characteristics of acute cholangitis. Acta Radiol 2002; 43 (2) 175-179
    CrossrefPubMedGoogle Scholar
  • 16 Katabathina VS, Dasyam AK, Dasyam N, Hosseinzadeh K. Adult bile duct strictures: role of MR imaging and MR cholangiopancreatography in characterization. Radiographics 2014; 34 (3) 565-586
    CrossrefPubMedGoogle Scholar
  • 17 Baron RL, Tublin ME, Peterson MS. Imaging the spectrum of biliary tract disease. Radiol Clin North Am 2002; 40 (6) 1325-1354
    CrossrefPubMedGoogle Scholar
  • 18 Aksoy DY, Kerimoğlu U, Oto A , et al. Fasciola hepatica infection: clinical and computerized tomographic findings of ten patients. Turk J Gastroenterol 2006; 17 (1) 40-45
    PubMedGoogle Scholar
  • 19 Czermak BV, Akhan O, Hiemetzberger R , et al. Echinococcosis of the liver. Abdom Imaging 2008; 33 (2) 133-143
    CrossrefPubMedGoogle Scholar
  • 20 Marrone G, Crino' F, Caruso S , et al. Multidisciplinary imaging of liver hydatidosis. World J Gastroenterol 2012; 18 (13) 1438-1447
    CrossrefPubMedGoogle Scholar
  • 21 Kodama Y, Fujita N, Shimizu T , et al. Alveolar echinococcosis: MR findings in the liver. Radiology 2003; 228 (1) 172-177
    CrossrefPubMedGoogle Scholar
  • 22 McManus DP, Zhang W, Li J, Bartley PB. Echinococcosis. Lancet 2003; 362 (9392): 1295-1304
    CrossrefPubMedGoogle Scholar
  • 23 Stamm B, Fejgl M, Hueber C. Satellite cysts and biliary fistulas in hydatid liver disease. A retrospective study of 17 liver resections. Hum Pathol 2008; 39 (2) 231-235
    CrossrefPubMedGoogle Scholar
  • 24 Yücesoy AN, Poçan S. Secondary gallbladder hydatidosis and nonfragmanted germinative membrane sourced obstructive jaundice caused by intrabiliary ruptured hepatic hydatid cyst (a case report): two rare complication of the intrabiliary ruptured hepatic hydatid cyst. Hepatobiliary Surg Nutr 2014; 3 (4) 209-211
    PubMedGoogle Scholar
  • 25 Arifuddin R, Baichi M, Ullah A, Maliakkal B. Cystic Echinococcus--a rare presentation of acute biliary obstruction and pancreatitis. J Clin Gastroenterol 2006; 40 (8) 763-764
    CrossrefPubMedGoogle Scholar
  • 26 Graeter T, Ehing F, Oeztuerk S , et al. Hepatobiliary complications of alveolar echinococcosis: A long-term follow-up study. World J Gastroenterol 2015; 21 (16) 4925-4932
    CrossrefPubMedGoogle Scholar
  • 27 Manzella A, Ohtomo K, Monzawa S, Lim JH. Schistosomiasis of the liver. Abdom Imaging 2008; 33 (2) 144-150
    CrossrefPubMedGoogle Scholar
  • 28 Shaker Y, Samy N, Ashour E. Hepatobiliary schistosomiasis. J Clin Transl Hepatol 2014; 2 (3) 212-216
    PubMedGoogle Scholar
  • 29 Pereira TA, Syn WK, Machado MV , et al. Schistosome-induced cholangiocyte proliferation and osteopontin secretion correlate with fibrosis and portal hypertension in human and murine schistosomiasis mansoni. Clin Sci (Lond) 2015; 129 (10) 875-883
    CrossrefPubMedGoogle Scholar
  • 30 Brant PE, Kopke-Aguiar L, Shigueoka DC , et al. Anicteric cholangiopathy in schistosomiasis patients. Acta Trop 2008; 108 (2-3): 218-221
    CrossrefPubMedGoogle Scholar
  • 31 Oliveira L, Andrade ZA. Significance of bile-duct changes in schistosomiasis. Rev Soc Bras Med Trop 2005; 38 (6) 464-468
    CrossrefPubMedGoogle Scholar
  • 32 Bethony J, Brooker S, Albonico M , et al. Soil-transmitted helminth infections: ascariasis, trichuriasis, and hookworm. Lancet 2006; 367 (9521): 1521-1532
    CrossrefPubMedGoogle Scholar
  • 33 Chakrabarti I, Giri A, De A, Roy AC. Radio-pathological diagnosis of hepatobiliary ascariasis: a rare entity. J Cytol 2011; 28 (3) 114-116
    CrossrefPubMedGoogle Scholar
  • 34 Das CJ, Kumar J, Debnath J, Chaudhry A. Imaging of ascariasis. Australas Radiol 2007; 51 (6) 500-506
    CrossrefPubMedGoogle Scholar
  • 35 Akata D, Ozmen MN, Kaya A, Akhan O. Radiological findings of intraparenchymal liver Ascaris (hepatobiliary ascariasis). Eur Radiol 1999; 9 (1) 93-95
    CrossrefPubMedGoogle Scholar
  • 36 Hwang CM, Kim TK, Ha HK, Kim PN, Lee MG. Biliary ascariasis: MR cholangiography findings in two cases. Korean J Radiol 2001; 2 (3) 175-178
    CrossrefPubMedGoogle Scholar
  • 37 Ng KK, Wong HF, Kong MS, Chiu LC, Tan CF, Wan YL. Biliary ascariasis: CT, MR cholangiopancreatography, and navigator endoscopic appearance--report of a case of acute biliary obstruction. Abdom Imaging 1999; 24 (5) 470-472
    CrossrefPubMedGoogle Scholar
  • 38 Paganelli M, Taglietti L, Di Flumeri G, Giovanetti M. Rare cause of biliary obstruction by ascariasis associated with choledocholithiasis. Chir Ital 2008; 60 (5) 733-738
    PubMedGoogle Scholar
  • 39 Slesak G, Phanthavong P, Rasphone O , et al. Obstructive biliary ascariasis with cholangitis and hepatic abscesses in Laos: a case report with gall bladder ultrasound video. J Infect 2007; 54 (4) e233 –e235
    CrossrefPubMedGoogle Scholar
  • 40 Koumanidou C, Manoli E, Anagnostara A, Polyviou P, Vakaki M. Sonographic features of intestinal and biliary ascariasis in childhood: case report and review of the literature. Ann Trop Paediatr 2004; 24 (4) 329-335
    CrossrefPubMedGoogle Scholar
  • 41 Sharma M. Echogenic shadow in the common bile duct. Diagnosis: biliary ascariasis. Gastroenterology 2011; 141 (1) e14 –e15
    PubMedGoogle Scholar
  • 42 Al Absi M, Qais AM, Al Katta M, Gafour M, Al-Wadan AH. Biliary ascariasis: the value of ultrasound in the diagnosis and management. Ann Saudi Med 2007; 27 (3) 161-165
    CrossrefPubMedGoogle Scholar
  • 43 Adaletli I, Selçuk D, Gülşen M, Savaş C, Korman U. MRCP findings of biliary ascariasis before and after medical treatment. Turk J Gastroenterol 2005; 16 (2) 98-101
    PubMedGoogle Scholar
  • 44 Fitoz S, Atasoy C. MR cholangiography in massive hepatobiliary ascariasis. A case report. Acta Radiol 2000; 41 (3) 273-274
    CrossrefPubMedGoogle Scholar
  • 45 Lynser D, Marbaniang E. Hepatobiliary and pancreatic ascariasis-sonographic pictorial essay on four pediatric cases with acute biliary colic. Emerg Radiol 2016; 23 (2) 197-200
    CrossrefPubMedGoogle Scholar
  • 46 Seaman DL, Chahal P, Sanderson SO, Baron TH, Topazian MD. Biliary cryptosporidiosis in a patient without HIV infection: endosonographic, cholangiographic, and histologic features (with video). Gastrointest Endosc 2009; 70 (3) 590-592
    CrossrefPubMedGoogle Scholar
  • 47 Lefkowitch JH. Pathology of AIDS-related liver disease. Dig Dis 1994; 12 (6) 321-330
    CrossrefPubMedGoogle Scholar
  • 48 Ducreux M, Buffet C, Lamy P , et al. Diagnosis and prognosis of AIDS-related cholangitis. AIDS 1995; 9 (8) 875-880
    CrossrefPubMedGoogle Scholar
  • 49 Forbes A, Blanshard C, Gazzard B. Natural history of AIDS related sclerosing cholangitis: a study of 20 cases. Gut 1993; 34 (1) 116-121
    CrossrefPubMedGoogle Scholar
  • 50 Grumbach K, Coleman BG, Gal AA , et al. Hepatic and biliary tract abnormalities in patients with AIDS. Sonographic-pathologic correlation. J Ultrasound Med 1989; 8 (5) 247-254
    CrossrefPubMedGoogle Scholar
  • 51 Hashmey R, Smith NH, Cron S, Graviss EA, Chappell CL, White Jr AC. Cryptosporidiosis in Houston, Texas. A report of 95 cases. Medicine (Baltimore) 1997; 76 (2) 118-139
    CrossrefPubMedGoogle Scholar
  • 52 Tyagi I, Puri AS, Sakhuja P, Majumdar K, Lunia M, Gondal R. Co-occurrence of cytomegalovirus-induced vanishing bile duct syndrome with papillary stenosis in HIV infection. Hepatol Res 2013; 43 (3) 311-314
    CrossrefPubMedGoogle Scholar
  • 53 Kapelusznik L, Arumugam V, Caplivski D, Bottone EJ. Disseminated histoplasmosis presenting as AIDS cholangiopathy. Mycoses 2011; 54 (3) 262-264
    CrossrefPubMedGoogle Scholar
  • 54 Devarbhavi H, Sebastian T, Seetharamu SM, Karanth D. HIV/AIDS cholangiopathy: clinical spectrum, cholangiographic features and outcome in 30 patients. J Gastroenterol Hepatol 2010; 25 (10) 1656-1660
    CrossrefPubMedGoogle Scholar
  • 55 Yusuf TE, Baron TH. AIDS cholangiopathy. Curr Treat Options Gastroenterol 2004; 7 (2) 111-117
    CrossrefPubMedGoogle Scholar
  • 56 Tonolini M, Bianco R. HIV-related/AIDS cholangiopathy: pictorial review with emphasis on MRCP findings and differential diagnosis. Clin Imaging 2013; 37 (2) 219-226
    CrossrefPubMedGoogle Scholar
  • 57 Bilgin M, Balci NC, Erdogan A, Momtahen AJ, Alkaade S, Rau WS. Hepatobiliary and pancreatic MRI and MRCP findings in patients with HIV infection. AJR Am J Roentgenol 2008; 191 (1) 228-232
    CrossrefPubMedGoogle Scholar
  • 58 Takahashi H, Falk GA, Cruise M, Morris-Stiff G. Chronic cholecystitis with Cystoisospora belli in an immunocompetent patient. BMJ Case Rep 2015; 2015: bcr2015209966
    PubMedGoogle Scholar
  • 59 Megremis S, Segkos N, Daskalaki M , et al. Gallbladder cryptosporidiosis in a patient with acquired immunodeficiency syndrome: sonographic evaluation of the disease's course. J Ultrasound Med 2004; 23 (1) 137-140
    CrossrefPubMedGoogle Scholar
  • 60 Zar FA, El-Bayoumi E, Yungbluth MM. Histologic proof of acalculous cholecystitis due to Cyclospora cayetanensis . Clin Infect Dis 2001; 33 (12) E140 –E141
    CrossrefPubMedGoogle Scholar
  • 61 Nash JA, Cohen SA. Gallbladder and biliary tract disease in AIDS. Gastroenterol Clin North Am 1997; 26 (2) 323-335
    CrossrefPubMedGoogle Scholar
  • 62 Nemes B, Gámán G, Doros A. Biliary complications after liver transplantation. Expert Rev Gastroenterol Hepatol 2015; 9 (4) 447-466
    CrossrefPubMedGoogle Scholar
  • 63 Karimian N, Westerkamp AC, Porte RJ. Biliary complications after orthotopic liver transplantation. Curr Opin Organ Transplant 2014; 19 (3) 209-216
    CrossrefPubMedGoogle Scholar
  • 64 Luo Y, Ji WB, Duan WD, Ye S, Dong JH. Graft cholangiopathy: etiology, diagnosis, and therapeutic strategies. Hepatobiliary Pancreat Dis Int 2014; 13 (1) 10-17
    CrossrefPubMedGoogle Scholar
  • 65 Wojcicki M, Milkiewicz P, Silva M. Biliary tract complications after liver transplantation: a review. Dig Surg 2008; 25 (4) 245-257
    CrossrefPubMedGoogle Scholar
  • 66 Stine JG, Chalasani N. Chronic liver injury induced by drugs: a systematic review. Liver Int 2015; 35 (11) 2343-2353
    CrossrefPubMedGoogle Scholar
  • 67 den Dulk AC, Wasser MN, Willemssen FE , et al. Value of magnetic resonance cholangiopancreatography in assessment of nonanastomotic biliary strictures after liver transplantation. Transplant Direct 2015; 1 (10) e42
    PubMedGoogle Scholar
  • 68 Civelli EM, Meroni R, Cozzi G , et al. The role of interventional radiology in biliary complications after orthotopic liver transplantation: a single-center experience. Eur Radiol 2004; 14 (4) 579-582
    CrossrefPubMedGoogle Scholar
  • 69 Romero FA, Razonable RR. Infections in liver transplant recipients. World J Hepatol 2011; 3 (4) 83-92
    CrossrefPubMedGoogle Scholar
  • 70 Koffron A, Stein JA. Liver transplantation: indications, pretransplant evaluation, surgery, and posttransplant complications. Med Clin North Am 2008; 92 (4) 861-888 , ix
    CrossrefPubMedGoogle Scholar
  • 71 Linden PK. Approach to the immunocompromised host with infection in the intensive care unit. Infect Dis Clin North Am 2009; 23 (3) 535-556
    CrossrefPubMedGoogle Scholar
  • 72 Kim JM, Kim SJ, Joh JW , et al. Early and delayed onset cytomegalovirus infection of liver transplant recipients in endemic areas. Transplant Proc 2010; 42 (3) 884-889
    CrossrefPubMedGoogle Scholar