Diagnosis of intramural bile duct varicosis ("pseudo-cholangiocarcinoma sign").

We report the case of a patient with portal hypertension and portal vein th rombosis who was admitted to hospital for evaluation prior to a scheduled p ortosystemic shunt operation. Ultrasound examination revealed dilatation of intrahepatic bile ducts and echogenic thickening of the walls of both righ t and left main bile ducts as well as the common bite duct, highly suspicio us of a carcinoma. Further evaluation, however, showed a varicosis of the b ile duct walls to be the cause of the thickening of the walls, the varicosi s resulting from the long-standing cavernous transformation of the portal v ein and the portal hypertension. This tumour-like thickening of the walls, caused by numerous tiny Varicose veins, is also known as "Pseudo-cholangioc arcinoma sign" in the Angle-American world.