Ultrasound images Dilated biliary tree and ascites

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Figure (A,B,C,D)
Caroli’s disease. (A) Dilated biliary tree and ascites. (B) TS of a different patient with end-stage disease.
The grossly abnormal liver texture contrasts with the right kidney. (C) A small section of focal CBD dilatation persisted
in a symptomatic patient, with normal-calibre distal CBD. This was confirmed on ERCP and thought to be a dyskinetic
segment, causing biliary reflux, but was later diagnosed as a mild form of Caroli’s. (D) 3D CT reconstruction of the case
in (C), confirming the ultrasound appearances. Note the tiny ectatic ‘pouchings’ of the intrahepatic ducts characteristic
of Caroli’s.
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