Bile Plug Syndrome

  • Etiology: inspissated bile obstructs the extrahepatic biliary tree, can be due to cystic fibrosis, hepatocellular damage, total parenteral nutrition, erythroblastic jaundice,
  • Imaging: sludge in gallbladder or bile ducts visualized as large filling defects in the biliary tree leading to biliary obstruction, gall bladder wall thickening
  • DDX: cholelithiasis
  • Treatment: biliary lavage via percutaneous cholangiogram can be used to flush the inspissated bile out of the biliary tree
  • Clinical: hyperbilirubinemia

Radiology Cases of Bile Plug Syndrome

Percutaneous cholangiogram of bile plug syndrome
AP image from a percutaneous cholangiogram shows a dilated intrahepatic biliary tree and a markedly dilated extrahepatic biliary tree containing large filling defects within it. In this case the cholangiogram was therapeutic as well as diagnostic.