Portal biliopathy with benign stricture of CBD. Note splenomegaly.

Portal biliopathy is referable to biliary ductal changes in patients with portal hypertension. It is common in portal vein thrombosis and less often in cirrhosis and non cirrhotic portal fibrosis.

The changes include stricture and dilatation of both extrahepatic and intrahepatic bile duct secondary to varices encircling CBD and GB wall. When these changes become significant the individual manifests with obstructive jaundice.

Based on location and extent of cholangioghraphic abnormalities a simple classification of portal biliopathy has been proposed:

 

TYPE I: Involvement of extrahepatic bile duct

TYPE II :    Involvement of intrahepatic bile duct

TYPE III :   Involvement of extrahepatic bile duct and unilateral intrahepatic bile duct (left or right)

TYPE IV : Involvement of extrahepatic bile duct and bilateral intrahepatic bile duct

 

Differential Diagnosis: CBD calculi with stricture formation, primary sclerosing cholangitis, biliary ascariasis.