A 55-year-old man with painless progressive jaundice undergoes CECT, which shows marked dilatation of the right and left intrahepatic ducts up to their confluence, where there is an enhancing soft tissue mass. The common bile duct and gallbladder are normal in calibre. The most likely diagnosis is:
- A Carcinoma of the head of pancreas
- B Klatskin tumour ✓
- C Mirizzi syndrome
- D Choledocholithiasis at the ampulla
Correct answer: B. Klatskin tumour
Explanation
B Klatskin tumour is a hilar cholangiocarcinoma arising at the confluence of the right and left hepatic ducts. It produces marked intrahepatic biliary dilatation with a normal or collapsed common bile duct and gallbladder because the obstruction sits above the cystic duct insertion. B periampullary or pancreatic head carcinoma dilates both the intrahepatic and extrahepatic ducts and gallbladder, and Mirizzi syndrome produces obstruction by an impacted cystic duct stone with extrinsic compression.
Reference: Bailey and Love's Short Practice of Surgery, 27th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.