Figure 13 (A-D).

A 68-year-old woman presenting with epigastric pain was found to have a biliary-enteric fistula between the left hepatic duct and gastric cardia. Axial portal venous phase CT scans show balloon like dilated left hepatic ducts and thickening of the adjacent gastric wall. Communication between the dilated duct and the gastric lumen is seen (arrows). Coronal MinIP image (C), demonstrates the fistulous tract (arrows) better. The ERCP image (D) shows severe dilatation of the left duct with multiple cord-like filling defects (arrows) that represent mucin in the duct. The contrast-filled gastric lumen and normal gastric folds (arrowheads) are also observed simultaneously