March 2014 Case of the Month

A previously healthy 35 yo male presented to the ED with one week of progressive painless jaundice.  A bedside ultrasound revealed the following:

 

klatskin with color and arro intrahepatic biliary dil color

The US images demonstrate an OBSTRUCTIVE jaundice, i.e. a dilated CBD as well as dilated intrahepatic ducts.  There is a tumor in the CBD near the point where it bifurcates into left and right hepatic ducts.

Interestingly, the patient’s family history was significant for two members with pancreatic CA.

Further testing demonstrated that the patient had cholangiocarcinoma (aka “Klatskin tumor”) .