Abstract
A 76-year-old woman with hepatic dysfunction was admitted and demonstrated intrahepatic bile duct dilatation and a hepatic cyst on abdominal US and CT, which measured 7 cm in diameter and occupied most of the segment of stenosis of S5. Because ERC showed the proximal bile duct, the possibility of bile duct cancer could not be ruled out and PTCD and percutaneous transhepatic cholangioscopy (PTCS) were performed. On PTCS, the bile duct in the stenotic site was slit-like in shape, and its wall was blue and swollen. On intraductal ultrasonography performed under PTCS, an echo-free space was observed in contact with the outer wall of the stenotic bile duct. From these findings, we diagnosed biliary stenosis due to compression by the hepatic cyst, and treated this case with percutaneous intracystic ethanol injection.
