Biliary actinomycosis mimicking common hepatic duct cancer
A 45-year-old woman was admitted urgently with right upper abdominal pain and mechanical jaundice (total bilirubin 2.6 mg/dL). Transabdominal ultrasonography raised concerns about calculous cholecystitis and common bile duct stones. ERCP revealed a proximal common hepatic duct (CHD) stricture without stones (A). Cholangioscopy (SpyGlass DSII; Boston Scientific Corporation [BSC], Marlborough, Mass, USA) confirmed a semicircular dense stricture. Additionally, an unknown 3- to 4-mm whitish hollow formation was seen in the right hepatic duct (B).
