Cholangiographic appearance in clonorchiasis.

Clonorchiasis may lead to cholangitis. Clonorchis sinensis infiltration of the biliary system produces an easily recognisable cholangiographic picture. The findings consist of characteristic filling defects and changes in the intrahepatic and extrahepatic ducts. The filling defects are usually small and irregular and the size is uniform. The change in the intrahepatic ducts consists of ductal dilatation involving especially the smaller ducts, apparent elongation, tortuosity and duct wall irregularities. The changes in the extrahepatic ducts consist mainly of duct wall irregularities and a mild degree of dilatation. The recognition is important as the management may have to be modified if cholangitis is the result of clonorchiasis alone.