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Ischemic Cholangiopathy: A Rare Manifestation in Hereditary Hemorrhagic Telangiectasia

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Resumo:Abstract Hereditary Hemorrhagic Telangiectasia (HHT) is an autosomal dominant disorder characterized by skin and mucosal telangiectasias and visceral arteriovenous malformations (AVMs). We report a case of ischemic cholangiopathy in a 60-year-old female with HHT who initially presented with intermittent biliary colic and no significant medical history. The absence of typical HHT symptoms made imaging crucial for diagnosis. Abdominal ultrasound, CT, and MRI revealed hepatic artery dilatation, hepatic AVMs and bilomas. In this setting, the bilomas result from biliary ductal necrosis due to arterial shunting induced by AVMs. Although the patient initially presented without common HHT manifestations such as epistaxis, a subsequent reassessment during the physical exam identified mucocutaneous telangiectasias, and genetic testing later confirmed the diagnosis. This case highlights the importance of recognizing specific imaging features to diagnose and understand the implications of ischemic cholangiopathy, a rare but distinct phenotype in patients with HHT.
Autores principais:Silva,Maria J.
Outros Autores:Ferreira,José M.; Torres,Tiago P.; Simões,Ana M.; Mendes,Hugo T.; Oliveira,Pedro G.
Assunto:Hereditary hemorrhagic telangiectasia Osler-Weber-Rendu Liver Arteriovenous malformations Ischemic cholangiopathy Biloma.
Ano:2025
País:Portugal
Tipo de documento:relatório
Tipo de acesso:acesso aberto
Instituição associada:Fundação para a Ciência e Tecnologia
Idioma:inglês
Origem:SciELO Portugal
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author Silva,Maria J.
author2 Ferreira,José M.
Torres,Tiago P.
Simões,Ana M.
Mendes,Hugo T.
Oliveira,Pedro G.
author2_role author
author
author
author
author
author_facet Silva,Maria J.
Ferreira,José M.
Torres,Tiago P.
Simões,Ana M.
Mendes,Hugo T.
Oliveira,Pedro G.
author_role author
country_str PT
creators_json_txt [{\"Person.name\":\"Silva,Maria J.\"},{\"Person.name\":\"Ferreira,José M.\"},{\"Person.name\":\"Torres,Tiago P.\"},{\"Person.name\":\"Simões,Ana M.\"},{\"Person.name\":\"Mendes,Hugo T.\"},{\"Person.name\":\"Oliveira,Pedro G.\"}]
datacite.creators.creator.creatorName.fl_str_mv Silva,Maria J.
Ferreira,José M.
Torres,Tiago P.
Simões,Ana M.
Mendes,Hugo T.
Oliveira,Pedro G.
datacite.rights.fl_str_mv http://purl.org/coar/access_right/c_abf2
datacite.subjects.subject.fl_str_mv Hereditary hemorrhagic telangiectasia
Osler-Weber-Rendu
Liver
Arteriovenous malformations
Ischemic cholangiopathy
Biloma.
datacite.titles.title.fl_str_mv Ischemic Cholangiopathy: A Rare Manifestation in Hereditary Hemorrhagic Telangiectasia
dc.creator.none.fl_str_mv Silva,Maria J.
Ferreira,José M.
Torres,Tiago P.
Simões,Ana M.
Mendes,Hugo T.
Oliveira,Pedro G.
dc.format.none.fl_str_mv text/html
dc.identifier.none.fl_str_mv http://scielo.pt/scielo.php?script=sci_arttext&pid=S2183-13512025000200027
dc.language.none.fl_str_mv eng
dc.publisher.none.fl_str_mv Sociedade Portuguesa de Radiologia e Medicina Nuclear
dc.rights.none.fl_str_mv http://purl.org/coar/access_right/c_abf2
dc.source.none.fl_str_mv Acta Radiológica Portuguesa v.37 n.2 2025
dc.subject.none.fl_str_mv Hereditary hemorrhagic telangiectasia
Osler-Weber-Rendu
Liver
Arteriovenous malformations
Ischemic cholangiopathy
Biloma.
dc.title.fl_str_mv Ischemic Cholangiopathy: A Rare Manifestation in Hereditary Hemorrhagic Telangiectasia
dc.type.none.fl_str_mv http://purl.org/coar/resource_type/c_93fc
description Abstract Hereditary Hemorrhagic Telangiectasia (HHT) is an autosomal dominant disorder characterized by skin and mucosal telangiectasias and visceral arteriovenous malformations (AVMs). We report a case of ischemic cholangiopathy in a 60-year-old female with HHT who initially presented with intermittent biliary colic and no significant medical history. The absence of typical HHT symptoms made imaging crucial for diagnosis. Abdominal ultrasound, CT, and MRI revealed hepatic artery dilatation, hepatic AVMs and bilomas. In this setting, the bilomas result from biliary ductal necrosis due to arterial shunting induced by AVMs. Although the patient initially presented without common HHT manifestations such as epistaxis, a subsequent reassessment during the physical exam identified mucocutaneous telangiectasias, and genetic testing later confirmed the diagnosis. This case highlights the importance of recognizing specific imaging features to diagnose and understand the implications of ischemic cholangiopathy, a rare but distinct phenotype in patients with HHT.
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eu_rights_str_mv openAccess
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inst_facet_str urn:organizationAcronym:scielo{{{_:::_}}}Fundação para a Ciência e Tecnologia
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person_str_mv Silva,Maria J.
Ferreira,José M.
Torres,Tiago P.
Simões,Ana M.
Mendes,Hugo T.
Oliveira,Pedro G.
publishDate 2025
publisher.none.fl_str_mv Sociedade Portuguesa de Radiologia e Medicina Nuclear
repo_facet_str urn:repositoryAcronym:scielopt{{{_:::_}}}SciELO Portugal
reponame_str SciELO Portugal
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spelling Ischemic Cholangiopathy: A Rare Manifestation in Hereditary Hemorrhagic TelangiectasiaSilva,Maria J.Ferreira,José M.Torres,Tiago P.Simões,Ana M.Mendes,Hugo T.Oliveira,Pedro G.Hereditary hemorrhagic telangiectasiaOsler-Weber-RenduLiverArteriovenous malformationsIschemic cholangiopathyBiloma.open accesshttp://purl.org/coar/access_right/c_abf2http://scielo.pt/scielo.php?script=sci_arttext&pid=S2183-13512025000200027URLhttp://scielo.pt/scielo.php?script=sci_arttext&pid=S2183-13512025000200027URLHasVersion2025-08-01Abstract Hereditary Hemorrhagic Telangiectasia (HHT) is an autosomal dominant disorder characterized by skin and mucosal telangiectasias and visceral arteriovenous malformations (AVMs). We report a case of ischemic cholangiopathy in a 60-year-old female with HHT who initially presented with intermittent biliary colic and no significant medical history. The absence of typical HHT symptoms made imaging crucial for diagnosis. Abdominal ultrasound, CT, and MRI revealed hepatic artery dilatation, hepatic AVMs and bilomas. In this setting, the bilomas result from biliary ductal necrosis due to arterial shunting induced by AVMs. Although the patient initially presented without common HHT manifestations such as epistaxis, a subsequent reassessment during the physical exam identified mucocutaneous telangiectasias, and genetic testing later confirmed the diagnosis. This case highlights the importance of recognizing specific imaging features to diagnose and understand the implications of ischemic cholangiopathy, a rare but distinct phenotype in patients with HHT.Sociedade Portuguesa de Radiologia e Medicina NuclearActa Radiológica Portuguesa v.37 n.2 2025text/htmlengreporthttp://purl.org/coar/resource_type/c_93fcother research product
spellingShingle Ischemic Cholangiopathy: A Rare Manifestation in Hereditary Hemorrhagic Telangiectasia
Silva,Maria J.
Hereditary hemorrhagic telangiectasia
Osler-Weber-Rendu
Liver
Arteriovenous malformations
Ischemic cholangiopathy
Biloma.
status SINGLETON
subject.fl_str_mv Hereditary hemorrhagic telangiectasia
Osler-Weber-Rendu
Liver
Arteriovenous malformations
Ischemic cholangiopathy
Biloma.
title Ischemic Cholangiopathy: A Rare Manifestation in Hereditary Hemorrhagic Telangiectasia
title_full Ischemic Cholangiopathy: A Rare Manifestation in Hereditary Hemorrhagic Telangiectasia
title_fullStr Ischemic Cholangiopathy: A Rare Manifestation in Hereditary Hemorrhagic Telangiectasia
title_full_unstemmed Ischemic Cholangiopathy: A Rare Manifestation in Hereditary Hemorrhagic Telangiectasia
title_short Ischemic Cholangiopathy: A Rare Manifestation in Hereditary Hemorrhagic Telangiectasia
title_sort Ischemic Cholangiopathy: A Rare Manifestation in Hereditary Hemorrhagic Telangiectasia
topic Hereditary hemorrhagic telangiectasia
Osler-Weber-Rendu
Liver
Arteriovenous malformations
Ischemic cholangiopathy
Biloma.
topic_facet Hereditary hemorrhagic telangiectasia
Osler-Weber-Rendu
Liver
Arteriovenous malformations
Ischemic cholangiopathy
Biloma.
url http://scielo.pt/scielo.php?script=sci_arttext&pid=S2183-13512025000200027
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