3-DIMENSIONAL HELICAL COMPUTED-TOMOGRAPHY WITH INTRAVENOUS CHOLANGIOGRAPHY FOR SCLEROSING CHOLANGITIS MANIFESTED AS POSTCHOLECYSTECTOMY SYMPTOM

A 46-year-old woman who had upper abdominal pain 10 years after cholec ystectomy, and who had incidental sclerosing cholangitis (SC), was inv estigated by three-dimensional helical computed tomographic (3-DHCT) c holangiography with contrast medium, because endoscopic retrograde cho langiography (ERC) was unsuccessful and a second ERC was not permitted by the patient. The cholangiogram demonstrated annular strictures of the bilateral hepatic duct at the confluence of the common hepatic duc t, and dilatation of the left intrahepatic biliary duct. Although we c ould not clarify the cause of the biliary tract deformity at the time of the 3-DHCT, the tentative diagnosis of postcholecystectomy deformit y of the biliary tree led to successful treatment by right liver lobec tomy and hepaticojejunostomy. Histologic findings were compatible with SC. From this experience and the literature, we suggest that 1-DHCT c holangiography with contrast medium can contribute to the preoperative diagnosis of morphological changes in the biliary tree in patients wi th postcholecystectomy symptoms.