Unusual outcome of percutaneous transhepatic cholangiography

In a 72-year old male with fever, mild jaundice and moderate enlargement of both liver and spleen, percutaneous transhepatic cholangiography resulted in direct filling of the portal vein system. Both trunc and left and right hepatic lobe branches showed a typical pattern of incomplete portal vein thrombosis, with mural irregularities and radiolucencies within the lumen. On subsequent operative cholangiography the biliary tract was shown to be normal. At autopsy multiple intrahepatic abscesses of pylephlebitic origin were found. The significance of visualization of the portal vein system during PTC is briefly discussed in comparison with other angiographic technics.