Oriental cholangiohepatitis: correlation between portal vein occlusion and hepatic atrophy

The angiographic features of the hepatic vasculature in patients with oriental cholangiohepatitis and their relationship to liver atrophy remain unclear. We studied 11 patients with oriental cholangiohepatitis to define the spectrum of portal vein, bile duct, and parenchymal involvement by correlating findings on cholangiography, sonography, CT, and angiography. The portal veins appeared normal in five cases, pruned in four, and completely obstructed in two. This spectrum of appearances was found to correlate with the severity of liver atrophy. No massive arterioportal shunting was found in any patients in this series. The two patients with complete obstruction of the portal veins showed no evidence of malignancy at histologic examination of the resected specimen. It is concluded that the degree of portal vein obstruction correlates well with the degree of liver atrophy in patients with oriental cholangiohepatitis and that findings of complete central portal obstruction do not necessarily indicate associated malignancy.