Misinterpretation of the severity of bile duct injuries by MRCP

Background: Magnetic resonance imaging (MRI) is widely regarded as the gold standard for assessment of the bile ducts in patients with bile duct injuries (BDIs). This case series aims to highlight the shortcomings of this imaging modality and demonstrate how it may overestimate the injury severity....

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Bibliographic Details
Published inSouth African journal of surgery Vol. 62; no. 2; pp. 190 - 193
Main Authors Bhana, M, Bernon, M, Kloppers, J.C, Jonas, E
Format Journal Article
LanguageEnglish
Published Medpharm Publications 01.06.2024
Subjects
Blood
Medical examination
Medical research
Medicine, Experimental
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Summary:Background: Magnetic resonance imaging (MRI) is widely regarded as the gold standard for assessment of the bile ducts in patients with bile duct injuries (BDIs). This case series aims to highlight the shortcomings of this imaging modality and demonstrate how it may overestimate the injury severity. Methods: Three patients treated at Groote Schuur Hospital and the University of Cape Town in whom MRI/magnetic resonance cholangiopancreatography (MRCP) overestimated the severity of BDI were included in the study. Demographic characteristics, clinical presentation, blood results and imaging findings are presented. Results: All patients had an MRI/MRCP done which assessed the BDIs as major complete cut-off of the proximal common hepatic duct with substance loss. Subsequent direct cholangiography showed minor injuries and all three patients were successfully managed with endoscopic stenting. Conclusion: Major BDIs are complex, and assessment of severity is intricate and may be overestimated. These patients are best managed in high-volume multidisciplinary team settings. Keywords: bile duct injury, magnetic resonance imaging, endoscopic retrograde cholangiography
ISSN:0038-2361
2078-5151
DOI:10.36303/SAJS.00411