A 30 year old man is referred to ultrasound forgeneralized right - ProProfs
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A 30-year-old man is referred to ultrasound forgeneralized right upper quadrant tenderness andearly signs of jaundice. His gallbladder appearsnormal, but there are bright focal areas withoutshadowing scattered throughout his liver. Onclose inspection, these areas are seen to be thewalls of the portal vein branches. What is first inthe list of differential diagnoses?



A. Hepatitis
B. Choledocholithiasis
C. Pneumobilia
Asked by C.Bancroft on Sep 08, 2016

This question is part of

Sanders Exam Prep (Liver)

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1 Answer

John Smith

John Smith

Answered on Sep 08, 2016

Hepatitis-jaundice brings to mind obstruction from choledocholithiasis, but with an absence of gallstones or shadowing throughout the liver a nonobstructive cause should be considered. a subtle increase in echogenicity of the portal triads is one of the few sonographic indications of hepatitis; however, this finding is not always present. it is possible that the increase in periportal echogenicity is caused by the decreased parenchymal echogenicity sometimes seen in hepatitis. pneumobilia would cause linear echogenicity with dirty shadowing. choledocholithiasis would be seen as one or more echogenic densities with acoustic shadowing.
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