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Ischemic Bile Duct Injury
Siva P. Raman, MD
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KEY FACTS

  • Terminology

    • Imaging

      • Pathology

        • Clinical Issues

          TERMINOLOGY

          • Synonyms

            • Ischemic cholangitis, ischemic cholangiopathy
          • Definitions

            • Nonanastomotic biliary strictures in liver allograft originally described in setting of hepatic artery thrombosis (HAT) or stenosis (HAS), but now known to occur due to a wide variety of other microangiopathic and immunological injuries

          IMAGING

          • General Features

            • Radiographic Findings

              • CT Findings

                • MR Findings

                  • Ultrasonographic Findings

                    • Imaging Recommendations

                      DIFFERENTIAL DIAGNOSIS

                        PATHOLOGY

                        • General Features

                          • Staging, Grading, & Classification

                            • Microscopic Features

                              CLINICAL ISSUES

                              • Presentation

                                • Demographics

                                  • Natural History & Prognosis

                                    • Treatment

                                      DIAGNOSTIC CHECKLIST

                                      • Consider

                                        • Image Interpretation Pearls

                                          Selected References

                                          1. Luo Y et al: Graft cholangiopathy: etiology, diagnosis, and therapeutic strategies. Hepatobiliary Pancreat Dis Int. 13(1):10-7, 2014
                                          2. Mourad MM et al: Etiology and management of hepatic artery thrombosis after adult liver transplantation. Liver Transpl. 20(6):713-23, 2014
                                          3. Imam MH et al: Secondary sclerosing cholangitis: pathogenesis, diagnosis, and management. Clin Liver Dis. 17(2):269-77, 2013
                                          4. Itri JN et al: Hepatic transplantation: postoperative complications. Abdom Imaging. 38(6):1300-33, 2013
                                          5. Yang YL et al: Biliary casts after liver transplantation: morphology and biochemical analysis. World J Gastroenterol. 19(43):7772-7, 2013
                                          6. Cursio R et al: Ischemia-reperfusion injury and ischemic-type biliary lesions following liver transplantation. J Transplant. 2012:164329, 2012
                                          7. Kinner S et al: Biliary complications after liver transplantation: addition of T1-weighted images to MR cholangiopancreatography facilitates detection of cast in biliary cast syndrome. Radiology. 263(2):429-36, 2012
                                          8. Collettini F et al: Ischemic-type biliary lesions after ortothopic liver transplantation: diagnosis with magnetic resonance cholangiography. Transplant Proc. 43(7):2660-3, 2011
                                          9. Kirchner GI et al: Outcome of patients with ischemic-like cholangiopathy with secondary sclerosing cholangitis after liver transplantation. Scand J Gastroenterol. 46(4):471-8, 2011
                                          10. Park YS et al: Hepatic arterial stenosis assessed with doppler US after liver transplantation: frequent false-positive diagnoses with tardus parvus waveform and value of adding optimal peak systolic velocity cutoff. Radiology. 260(3):884-91, 2011
                                          11. Katz LH et al: Magnetic resonance cholangiopancreatography for the accurate diagnosis of biliary complications after liver transplantation: comparison with endoscopic retrograde cholangiography and percutaneous transhepatic cholangiography - long-term follow-up. Clin Transplant. 24(5):E163-9, 2010
                                          12. Singh AK et al: Postoperative imaging in liver transplantation: what radiologists should know. Radiographics. 30(2):339-51, 2010
                                          13. Deltenre P et al: Ischemic cholangiopathy. Semin Liver Dis. 28(3):235-46, 2008
                                          14. Gelbmann CM et al: Ischemic-like cholangiopathy with secondary sclerosing cholangitis in critically ill patients. Am J Gastroenterol. 102(6):1221-9, 2007
                                          15. Verdonk RC et al: Nonanastomotic biliary strictures after liver transplantation, part 2: Management, outcome, and risk factors for disease progression. Liver Transpl. 13(5):725-32, 2007
                                          16. Buis CI et al: Causes and consequences of ischemic-type biliary lesions after liver transplantation. J Hepatobiliary Pancreat Surg. 13(6):517-24, 2006
                                          17. Ward J et al: Bile duct strictures after hepatobiliary surgery: assessment with MR cholangiography. Radiology. 231(1):101-8, 2004
                                          18. Quiroga S et al: Complications of orthotopic liver transplantation: spectrum of findings with helical CT. Radiographics. 21(5):1085-102, 2001
                                          19. Ward EM et al: Hilar biliary strictures after liver transplantation: cholangiography and percutaneous treatment. Radiology. 177(1):259-63, 1990
                                          20. Zajko AB et al: Cholangiographic findings in hepatic artery occlusion after liver transplantation. AJR Am J Roentgenol. 149(3):485-9, 1987
                                          Related Anatomy
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                                          Related Differential Diagnoses
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                                          References
                                          Tables

                                          Tables

                                          KEY FACTS

                                          • Terminology

                                            • Imaging

                                              • Pathology

                                                • Clinical Issues

                                                  TERMINOLOGY

                                                  • Synonyms

                                                    • Ischemic cholangitis, ischemic cholangiopathy
                                                  • Definitions

                                                    • Nonanastomotic biliary strictures in liver allograft originally described in setting of hepatic artery thrombosis (HAT) or stenosis (HAS), but now known to occur due to a wide variety of other microangiopathic and immunological injuries

                                                  IMAGING

                                                  • General Features

                                                    • Radiographic Findings

                                                      • CT Findings

                                                        • MR Findings

                                                          • Ultrasonographic Findings

                                                            • Imaging Recommendations

                                                              DIFFERENTIAL DIAGNOSIS

                                                                PATHOLOGY

                                                                • General Features

                                                                  • Staging, Grading, & Classification

                                                                    • Microscopic Features

                                                                      CLINICAL ISSUES

                                                                      • Presentation

                                                                        • Demographics

                                                                          • Natural History & Prognosis

                                                                            • Treatment

                                                                              DIAGNOSTIC CHECKLIST

                                                                              • Consider

                                                                                • Image Interpretation Pearls

                                                                                  Selected References

                                                                                  1. Luo Y et al: Graft cholangiopathy: etiology, diagnosis, and therapeutic strategies. Hepatobiliary Pancreat Dis Int. 13(1):10-7, 2014
                                                                                  2. Mourad MM et al: Etiology and management of hepatic artery thrombosis after adult liver transplantation. Liver Transpl. 20(6):713-23, 2014
                                                                                  3. Imam MH et al: Secondary sclerosing cholangitis: pathogenesis, diagnosis, and management. Clin Liver Dis. 17(2):269-77, 2013
                                                                                  4. Itri JN et al: Hepatic transplantation: postoperative complications. Abdom Imaging. 38(6):1300-33, 2013
                                                                                  5. Yang YL et al: Biliary casts after liver transplantation: morphology and biochemical analysis. World J Gastroenterol. 19(43):7772-7, 2013
                                                                                  6. Cursio R et al: Ischemia-reperfusion injury and ischemic-type biliary lesions following liver transplantation. J Transplant. 2012:164329, 2012
                                                                                  7. Kinner S et al: Biliary complications after liver transplantation: addition of T1-weighted images to MR cholangiopancreatography facilitates detection of cast in biliary cast syndrome. Radiology. 263(2):429-36, 2012
                                                                                  8. Collettini F et al: Ischemic-type biliary lesions after ortothopic liver transplantation: diagnosis with magnetic resonance cholangiography. Transplant Proc. 43(7):2660-3, 2011
                                                                                  9. Kirchner GI et al: Outcome of patients with ischemic-like cholangiopathy with secondary sclerosing cholangitis after liver transplantation. Scand J Gastroenterol. 46(4):471-8, 2011
                                                                                  10. Park YS et al: Hepatic arterial stenosis assessed with doppler US after liver transplantation: frequent false-positive diagnoses with tardus parvus waveform and value of adding optimal peak systolic velocity cutoff. Radiology. 260(3):884-91, 2011
                                                                                  11. Katz LH et al: Magnetic resonance cholangiopancreatography for the accurate diagnosis of biliary complications after liver transplantation: comparison with endoscopic retrograde cholangiography and percutaneous transhepatic cholangiography - long-term follow-up. Clin Transplant. 24(5):E163-9, 2010
                                                                                  12. Singh AK et al: Postoperative imaging in liver transplantation: what radiologists should know. Radiographics. 30(2):339-51, 2010
                                                                                  13. Deltenre P et al: Ischemic cholangiopathy. Semin Liver Dis. 28(3):235-46, 2008
                                                                                  14. Gelbmann CM et al: Ischemic-like cholangiopathy with secondary sclerosing cholangitis in critically ill patients. Am J Gastroenterol. 102(6):1221-9, 2007
                                                                                  15. Verdonk RC et al: Nonanastomotic biliary strictures after liver transplantation, part 2: Management, outcome, and risk factors for disease progression. Liver Transpl. 13(5):725-32, 2007
                                                                                  16. Buis CI et al: Causes and consequences of ischemic-type biliary lesions after liver transplantation. J Hepatobiliary Pancreat Surg. 13(6):517-24, 2006
                                                                                  17. Ward J et al: Bile duct strictures after hepatobiliary surgery: assessment with MR cholangiography. Radiology. 231(1):101-8, 2004
                                                                                  18. Quiroga S et al: Complications of orthotopic liver transplantation: spectrum of findings with helical CT. Radiographics. 21(5):1085-102, 2001
                                                                                  19. Ward EM et al: Hilar biliary strictures after liver transplantation: cholangiography and percutaneous treatment. Radiology. 177(1):259-63, 1990
                                                                                  20. Zajko AB et al: Cholangiographic findings in hepatic artery occlusion after liver transplantation. AJR Am J Roentgenol. 149(3):485-9, 1987