Too many ducts sign: a characteristic cholangiographic finding of clonorchiasis?

ABSTRACT

Clonorchiasis procucts diffuse dilatation of the small and medium sized intrahepatic bile ducts and its cholangiogram shows visualization of many bile ducts, especially, tertiary, quaternary, and more peripheral tributaries up to the 6th tributaries. In an attempt to clarify this cholangiographic sign quantitively, we counted the visualized smaller bile ducts in clonorchiasis and compared the number of visualized ducts in normal cholangiogram, recurrent pyogenic chlangitis and carcinoma of the extrahepatic ducts. In clonorchiasis the number of visualized smaller bile ducts was considerably geater than in normal subjects and recurrent pyogenic cholangitis, but there was no singnificant statistical differences in the number of visualized bile duct tributaries between clonorchiasis and carcinoma of the bile ducts. Thus it is considered that too many ducts sign is not a unique cholangiographic finding of clonorchiasis, but we believe that in the presence of this sign with other we l known cholangiographic findings, diagnosis of clonorchiasis is very easy.