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---
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title: "Dysmorphic Liver With Abnormal Bile Ducts"
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docid: "1cb8d652-5e83-4ee2-a762-bab56e2d107b"
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authors:
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value: "Atif Zaheer, MD, FSAR"
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name: "Dysmorphic Liver With Abnormal Bile Ducts"
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category: "Gastrointestinal"
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|
||||
pageDescription: "Dysmorphic Liver With Abnormal Bile Ducts"
|
||||
pageKeywords: "Gastrointestinal, Differential Diagnosis, Liver, Generic Imaging Patterns, Dysmorphic Liver With Abnormal Bile Ducts"
|
||||
pageTitle: "Dysmorphic Liver With Abnormal Bile Ducts | STATdx"
|
||||
enhancedTitle: "Dysmorphic Liver With Abnormal Bile Ducts"
|
||||
type: "DDX"
|
||||
breadcrumbs:
|
||||
- "Gastrointestinal"
|
||||
- "Differential Diagnosis"
|
||||
- "Liver"
|
||||
- "Generic Imaging Patterns"
|
||||
- "Dysmorphic Liver With Abnormal Bile Ducts"
|
||||
---
|
||||
## ESSENTIAL INFORMATION
|
||||
|
||||
- ### Key Differential Diagnosis Issues
|
||||
|
||||
|
||||
- Dysmorphic liver refers to distortion and scarring of parenchyma
|
||||
- May result from inflammation, infection, ischemia, or tumor
|
||||
- Or effects of treatment for these conditions
|
||||
- Distinguish among dilated ducts, periportal edema, and thrombosed portal or hepatic veins
|
||||
- Appearance will vary by modality
|
||||
- US: Dilated hepatic artery in cirrhosis may simulate dilated ducts
|
||||
- Color Doppler can resolve this issue
|
||||
- CT or MR: Periportal edema may simulate dilated ducts
|
||||
- Edema usually found surrounding vessels; bile duct lies on only one side
|
||||
- CECT: Unopacified veins may simulate ducts
|
||||
- Vessels > water attenuation
|
||||
- Cholangiography: Intrahepatic ducts may be distorted by masses or regenerating nodules, simulating cholangitis
|
||||
- ### Helpful Clues for Common Diagnoses
|
||||
|
||||
|
||||
- **Primary Sclerosing Cholangitis**
|
||||
- Often results in chronic liver damage
|
||||
- In patients with primary sclerosing cholangitis (PSC)-induced end-stage cirrhosis, liver is markedly deformed (to much greater extent than with other common causes of cirrhosis)
|
||||
- Lobular contour of liver with preferential scarring of periphery
|
||||
- Sparing and hypertrophy of caudate and deep right lobe
|
||||
- Sometimes to degree simulating central neoplastic mass (pseudotumoral enlargement of caudate)
|
||||
- Intrahepatic bile ducts show varying degrees of stricture and dilation with abnormal arborization (branching pattern)
|
||||
- Multifocal "beaded" strictures of intra- and extrahepatic ducts with intervening sites of dilated and normal ducts
|
||||
- Pruned appearance of biliary tree develops as disease progresses with obliteration of small peripheral ducts
|
||||
- Visualization of greater than expected number of peripheral ducts on MRCP is clue to presence of peripheral intrahepatic ductal strictures
|
||||
- **Cirrhosis (Mimic)**
|
||||
- Rarely causes ductal dilation
|
||||
- But may cause pathologic processes that simulate dilated ducts
|
||||
- Regenerating nodules may compress and distort intrahepatic ducts
|
||||
- **Peribiliary cysts** are dilated peribiliary glands; may simulate dilated ducts ± small cystic masses in portal triads
|
||||
- Periportal edema may simulate ducts
|
||||
- **Portal Vein Thrombophlebitis (Mimic)**
|
||||
- Thrombosed portal vein branches may simulate dilated ducts on CECT or MR
|
||||
- Primary thrombosis of portal vein (hypercoagulable states)
|
||||
- Produces characteristic distortion of liver that simulates cirrhosis
|
||||
- May result from subacute diverticulitis or appendicitis
|
||||
- Thrombosed portal veins may simulate dilated ducts
|
||||
- Liver may be damaged from infection or ischemia
|
||||
- Pyogenic abscesses, liver infarction, volume loss, etc.
|
||||
- **Cholangiocarcinoma,****Intrahepatic or Hilar**
|
||||
- Arising from confluence (Klatskin) or branch ducts (intrahepatic)
|
||||
- Ducts are dilated upstream from tumor
|
||||
- Liver parenchyma shows volume loss ± visualization of tumor
|
||||
- ### Helpful Clues for Less Common Diagnoses
|
||||
|
||||
|
||||
- **Budd-Chiari Syndrome**
|
||||
- Peripheral biliary ducts may get distorted and dilated due to central hepatic hypertrophy
|
||||
- Thrombosed hepatic veins may simulate dilated ducts but are more central
|
||||
- Liver is distorted with peripheral > central volume loss, scarring, hepatocellular necrosis and steatosis
|
||||
- Flip-flop enhancement: Early enhancement of central liver around IVC, decreased peripheral enhancement. Later decreased enhancement centrally with increased enhancement peripherally
|
||||
- **Primary Biliary Cholangitis**
|
||||
- Irregular and "pruned" ducts leading to vanishing bile duct syndrome as disease progresses
|
||||
- Lace-like fibrosis, prominent lymphadenopathy, and hepatomegaly (early) along with positive antimitochondrial antibody test
|
||||
- **Chemotherapy Cholangitis**
|
||||
- Intraarterial chemotherapy used for primary hepatocellular carcinoma or metastases
|
||||
- Liver distortion due to tumors and parenchymal scarring
|
||||
- Ducts are damaged and strictured with appearance like primary sclerosing cholangitis
|
||||
- **Ascending Cholangitis**
|
||||
- May lead to duct strictures; rarely to chronic liver injury
|
||||
- More common are hepatic abscesses
|
||||
- **AIDS Cholangiopathy**
|
||||
- Liver may be distorted by infection &/or tumor
|
||||
- Papillary stenosis with proximal common bile duct (CBD) dilation, strictures/ulcerations of CBD, and intrahepatic strictures: Unique to AIDS cholangiopathy
|
||||
- **Fibropolycystic Liver Diseases**
|
||||
- Encompasses spectrum of related lesions of liver and biliary tract caused by abnormal embryologic development of ductal plates
|
||||
- Lesions may occur in isolation or in any combination; may be clinically silent
|
||||
- Or, may cause cholangitis, portal hypertension, GI bleeding, infection, etc.
|
||||
- Liver may be distorted by congenital fibrosis (simulates cirrhosis) or by scarring (especially with Caroli disease)
|
||||
- Bile ducts may be primary site of pathology (e.g., Caroli disease), coexist with primary parenchymal disease (e.g., fibrosis), or be distorted by extrinsic mass effect
|
||||
- **Congenital hepatic fibrosis**
|
||||
- Dysmorphic liver, portal hypertension
|
||||
- Enlarged and possibly supernumerary hepatic arteries
|
||||
- **Caroli disease**
|
||||
- Dilatation (usually saccular) of large intrahepatic ducts with alternating biliary strictures
|
||||
- Liver often progressively damaged by cholangitis, obstruction
|
||||
- **Choledochal cyst**
|
||||
- Fusiform or cystic dilation of intrahepatic ± extrahepatic bile duct
|
||||
- **Biliary hamartomas**
|
||||
- Multiple "cysts" of nearly uniform size, up to 15 mm; no biliary connection
|
||||
- Mimic cysts on CT and MR but are often echogenic on US
|
||||
- Liver and bile ducts are normal unless coexisting disease, such as Caroli or congenital fibrosis
|
||||
- **Autosomal dominant polycystic disease, liver**
|
||||
- Distorts liver with innumerable cysts
|
||||
- Bile ducts intrinsically normal but may have extrinsic compression by cysts
|
||||
- **Recurrent Pyogenic Cholangitis**
|
||||
- Usually in Asian, poorly nourished populations
|
||||
- Liver distorted by chronic infection and biliary obstruction (abscesses, cirrhosis)
|
||||
- Bile ducts enormously dilated by pus and stones
|
||||
- **Hepatic Hydatid Disease**
|
||||
- Cysts may distort liver
|
||||
- Cysts may communicate with ducts, leading to cholangitis
|
||||
|
||||
|
||||
## Images
|
||||
|
||||
|
||||
### Selected Images
|
||||
|
||||
|
||||
**Primary Sclerosing Cholangitis**
|
||||
*Axial CECT shows a small liver with deep scars and lobular contour, typical of cirrhosis due to primary sclerosing cholangitis (PSC). Note the irregular dilation of intrahepatic ducts <img src='img/arrows/WS.png' alt='white solid arrow'/> and esophageal varices <img src='img/arrows/WC.png' alt='white curved arrow'/>.*
|
||||
|
||||
|
||||
**Primary Sclerosing Cholangitis**
|
||||
*Axial CECT shows a small liver with deep scars and lobular contour, typical of cirrhosis due to primary sclerosing cholangitis (PSC). Note the irregular dilation of intrahepatic ducts <img src='img/arrows/WS.png' alt='white solid arrow'/> and esophageal varices <img src='img/arrows/WC.png' alt='white curved arrow'/>.*
|
||||
|
||||
|
||||
**Primary Sclerosing Cholangitis**
|
||||
*ERCP shows segmental strictures <img src='img/arrows/WS.png' alt='white solid arrow'/> and "diverticula" <img src='img/arrows/WO.png' alt='white open arrow'/> involving the intra- and extrahepatic bile ducts, resulting in a beaded appearance of the ducts.*
|
||||
|
||||
|
||||
**Primary Sclerosing Cholangitis**
|
||||
*Coronal MRCP MIP in a 37-year-old man with PSC shows extensive intrahepatic strictures with alternating sites of narrowing and ductal dilatation.*
|
||||
|
||||
|
||||
**Hepatitis**
|
||||
*Axial CECT in a 47-year-old woman with autoimmune hepatitis shows evidence of periportal edema <img src='img/arrows/WC.png' alt='white curved arrow'/> that might be mistaken for dilated bile ducts, except that the lucent band extends completely around the portal vein branches.*
|
||||
|
||||
|
||||
**Peribiliary Cysts**
|
||||
*Axial CECT in a patient with advanced cirrhosis and ascites shows saccular and spherical cystic lesions <img src='img/arrows/WS.png' alt='white solid arrow'/> (peribiliary cysts) paralleling the portal triads.*
|
||||
|
||||
|
||||
**Peribiliary Cysts**
|
||||
*Axial CECT shows cirrhotic morphology of the liver with reduced size, wide fissures, and ascites noted. The portal vein branches <img src='img/arrows/BC.png' alt='black curved arrow'/> are surrounded by a collar of low density, some of which probably represents periportal edema; however, there are also discrete, low-density focal lesions <img src='img/arrows/WS.png' alt='white solid arrow'/> that represent periportal cysts within the bile duct walls.*
|
||||
|
||||
|
||||
**Portal Vein Thrombophlebitis (Mimic)**
|
||||
*Axial arterial-phase CECT shows hyperperfusion of the anterior right lobe of the liver <img src='img/arrows/BS.png' alt='black solid arrow'/> due to thrombosis of the anterior branch of the right portal vein. The thrombosed intrahepatic branches <img src='img/arrows/WS.png' alt='white solid arrow'/> might be mistaken for dilated bile ducts.*
|
||||
|
||||
|
||||
**Portal Vein Thrombophlebitis (Mimic)**
|
||||
*Axial CECT in a patient with transient hepatic attenuation difference (THAD) <img src='img/arrows/BS.png' alt='black solid arrow'/> due to thrombosis of the anterior right portal vein shows the increased size of the right hepatic artery <img src='img/arrows/BC.png' alt='black curved arrow'/> that is compensating for the decreased flow through the portal vein.*
|
||||
|
||||
|
||||
**Cholangiocarcinoma, Intrahepatic or Hilar**
|
||||
*Axial CECT shows a heterogeneous left lobe mass <img src='img/arrows/WO.png' alt='white open arrow'/> that obstructs intrahepatic ducts <img src='img/arrows/BC.png' alt='black curved arrow'/> and causes volume loss of the left lobe. This was a multifocal cholangiocarcinoma.*
|
||||
|
||||
|
||||
**Budd-Chiari Syndrome**
|
||||
*Axial CECT shows thrombosed hepatic veins <img src='img/arrows/WS.png' alt='white solid arrow'/> simulating dilated ducts. Ascites, peripheral hepatic damage, and central hypertrophy are typical findings of Budd-Chiari.*
|
||||
|
||||
|
||||
**Budd-Chiari Syndrome**
|
||||
*Dilatation of the biliary tree in the periphery of the liver <img src='img/arrows/WS.png' alt='white solid arrow'/> is due to caudate lobe hypertrophy <img src='img/arrows/WO.png' alt='white open arrow'/> and resulting narrowing of the biliary tree in the central liver as well as peripheral volume loss.*
|
||||
|
||||
|
||||
**Primary Biliary Cholangitis**
|
||||
*Coronal MRCP in a 58-year-old woman with primary biliary cholangitis shows signs of advanced disease with decreased visualization of the peripheral intrahepatic ducts (vanishing bile duct syndrome).*
|
||||
|
||||
|
||||
**Fibropolycystic Liver Diseases**
|
||||
*Axial CECT shows a dysmorphic liver with irregular dilation of intrahepatic ducts <img src='img/arrows/WC.png' alt='white curved arrow'/>. On lower sections, hepatic arteries were enlarged, and small, cystic kidneys were noted. All findings were related to fibropolycystic disease of the liver and kidneys, including congenital hepatic fibrosis.*
|
||||
|
||||
|
||||
**Caroli Disease**
|
||||
*Axial T2 MR shows cystic and irregular cylindrical dilation of intrahepatic bile ducts, characteristic of Caroli disease. Progressive liver failure resulted in transplantation.*
|
||||
|
||||
|
||||
**Recurrent Pyogenic Cholangitis**
|
||||
*Axial CECT shows dilated ducts <img src='img/arrows/WS.png' alt='white solid arrow'/> with a large pigment calculus <img src='img/arrows/CS.png' alt='cyan solid arrow'/> and a small liver abscess <img src='img/arrows/WC.png' alt='white curved arrow'/>.*
|
||||
|
||||
|
||||
**Hepatic Hydatid Disease**
|
||||
*Coronal CECT shows 2 large, cystic masses <img src='img/arrows/WS.png' alt='white solid arrow'/> with daughter cysts and a densely calcified cyst <img src='img/arrows/BS.png' alt='black solid arrow'/>. Bile ducts <img src='img/arrows/BC.png' alt='black curved arrow'/> are dilated due to communication of one of the cysts with the ducts.*
|
||||
|
||||
|
||||
### Additional Images
|
||||
|
||||
|
||||
**Cirrhosis (Mimic)**
|
||||
*Axial CECT shows a cirrhotic liver with ascites and splenomegaly. Intrahepatic ducts are irregularly dilated <img src='img/arrows/BS.png' alt='black solid arrow'/> in this case of mixed PSC and autoimmune hepatitis.*
|
||||
|
||||
|
||||
**Chemotherapy Cholangitis**
|
||||
*Axial CECT shows surgical absence of the lateral segment (resected metastasis) and a dilated bile duct <img src='img/arrows/WO.png' alt='white open arrow'/> following intraarterial chemotherapy.*
|
||||
|
||||
|
||||
**Chemotherapy Cholangitis**
|
||||
*Transhepatic cholangiogram shows irregular strictures <img src='img/arrows/WS.png' alt='white solid arrow'/> of the common hepatic and intrahepatic ducts as a result of intraarterial <img src='img/arrows/WC.png' alt='white curved arrow'/> chemotherapy for liver metastases.*
|
||||
|
||||
|
||||
**Caroli Disease**
|
||||
*Axial CECT in a patient with Caroli disease and congenital hepatic fibrosis shows dysmorphic liver and classic cystic dilation of intrahepatic ducts with central dot sign.*
|
||||
|
||||
|
||||
**Cholangiocarcinoma, Intrahepatic or Hilar**
|
||||
*Axial T2 MR shows gross dilation of the intrahepatic bile ducts <img src='img/arrows/WS.png' alt='white solid arrow'/>. There is no large mass <img src='img/arrows/WC.png' alt='white curved arrow'/> evident at the site of obstruction, typical of a hilar (Klatskin) tumor.*
|
||||
|
||||
|
||||
**Peribiliary Cysts**
|
||||
*Transverse US shows sonolucent saccular and spherical cystic lesions paralleling the portal triads, representing peribiliary cysts in this patient with cirrhosis and ascites.*
|
||||
|
||||
|
||||
**Hepatitis**
|
||||
*Axial CECT shows a mottled, distorted liver due to acute and chronic hepatitis. Periportal edema <img src='img/arrows/WS.png' alt='white solid arrow'/> might be mistaken for dilated ducts.*
|
||||
|
||||
|
||||
**Chemotherapy Cholangitis**
|
||||
*Axial CECT shows necrotic metastases <img src='img/arrows/BS.png' alt='black solid arrow'/> (from colon cancer) and mild dilation of the bile ducts <img src='img/arrows/BC.png' alt='black curved arrow'/>, a result of intraarterial chemotherapy.*
|
||||
|
||||
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+483
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+249
-19
@@ -76,7 +76,7 @@
|
||||
"docid": "c8256fa3-0694-412c-bd0f-8869f336ad90"
|
||||
},
|
||||
{
|
||||
"title": "Cystic or Necrotic Metastases",
|
||||
"title": "Hepatic Metastases and Lymphoma",
|
||||
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||||
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||||
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||||
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||||
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||||
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|
||||
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|
||||
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|
||||
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|
||||
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|
||||
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||||
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||||
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||||
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||||
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|
||||
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|
||||
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|
||||
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|
||||
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||||
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||||
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||||
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||||
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|
||||
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|
||||
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|
||||
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|
||||
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|
||||
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|
||||
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|
||||
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|
||||
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|
||||
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||||
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||||
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||||
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||||
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||||
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|
||||
"title": "Multiple Hepatic Cysts",
|
||||
"title": "Hepatic Cyst",
|
||||
"docid": "e525e5da-75e8-432c-b398-cb3d18e97771"
|
||||
},
|
||||
{
|
||||
@@ -200,7 +200,7 @@
|
||||
"docid": "c0b88320-bb06-4495-9830-70ea36e6cd9c"
|
||||
},
|
||||
{
|
||||
"title": "Differential Diagnosis",
|
||||
"title": "Cystic Hepatic Mass",
|
||||
"docid": "85bb9a0b-2d25-457d-a131-20ff07cb552b"
|
||||
},
|
||||
{
|
||||
@@ -224,7 +224,7 @@
|
||||
"docid": "6b7939de-9506-4ee2-944d-65766e04e5cf"
|
||||
},
|
||||
{
|
||||
"title": "Differential Diagnosis",
|
||||
"title": "Focal Liver Lesion With Hemorrhage",
|
||||
"docid": "5e6be44f-07d3-4569-abe3-798d7513fe41"
|
||||
},
|
||||
{
|
||||
@@ -252,7 +252,7 @@
|
||||
"docid": "5a0f58f1-beb9-459d-8246-83d6ddaf76db"
|
||||
},
|
||||
{
|
||||
"title": "Differential Diagnosis",
|
||||
"title": "Multiple Hypodense Liver Lesions",
|
||||
"docid": "5178ae9c-1ea9-4e06-9e8a-91e98d8708f6"
|
||||
},
|
||||
{
|
||||
@@ -344,6 +344,236 @@
|
||||
},
|
||||
"is_cached": true
|
||||
},
|
||||
{
|
||||
"path": "docs_md/articles/caroli-disease_acb4212f-766e-4766-bd10-1ebd525a467c.md",
|
||||
"title": "Caroli Disease",
|
||||
"docid": "acb4212f-766e-4766-bd10-1ebd525a467c",
|
||||
"breadcrumbs": [
|
||||
"Gastrointestinal",
|
||||
"Diagnosis",
|
||||
"Biliary System",
|
||||
"Congenital",
|
||||
"Caroli Disease"
|
||||
],
|
||||
"authors": [
|
||||
{
|
||||
"key": "c1df94ab-4a9f-44c4-add7-1f174fb9ac45",
|
||||
"value": "Siva P. Raman, MD"
|
||||
}
|
||||
],
|
||||
"pageKeywords": "Gastrointestinal, Diagnosis, Biliary System, Congenital, Caroli Disease",
|
||||
"reasons": [
|
||||
"Content"
|
||||
],
|
||||
"snippet": "...T2-hyperintense, nonenhancing cysts variably distributed in liver - Communication with biliary tree well visualized on MRCP - Cent...",
|
||||
"linked_info": {
|
||||
"anatomy": {
|
||||
"exists": true,
|
||||
"links": [
|
||||
{
|
||||
"title": "Anatomy Document",
|
||||
"docid": "6e9770b0-1f7b-4388-99ff-72e0014d0719"
|
||||
},
|
||||
{
|
||||
"title": "Anatomy Document",
|
||||
"docid": "e8a24564-9b11-46ee-88e6-cadab2d422f2"
|
||||
}
|
||||
]
|
||||
},
|
||||
"differential": {
|
||||
"exists": true,
|
||||
"links": [
|
||||
{
|
||||
"title": "Autosomal Dominant Polycystic Liver Disease",
|
||||
"docid": "c8256fa3-0694-412c-bd0f-8869f336ad90"
|
||||
},
|
||||
{
|
||||
"title": "Biliary Hamartoma",
|
||||
"docid": "1b525344-ad66-4381-9ca9-3fb11172744f"
|
||||
},
|
||||
{
|
||||
"title": "Primary Sclerosing Cholangitis",
|
||||
"docid": "7134d978-f567-4a1d-bfc8-75eb8816edd5"
|
||||
},
|
||||
{
|
||||
"title": "Ascending Cholangitis",
|
||||
"docid": "80ef96f3-87e6-43c2-a459-198cbeb427e3"
|
||||
},
|
||||
{
|
||||
"title": "Recurrent Pyogenic Cholangitis",
|
||||
"docid": "13f0134f-3495-48e3-8660-cdfb05c0a177"
|
||||
},
|
||||
{
|
||||
"title": "Cystic Hepatic Mass",
|
||||
"docid": "85bb9a0b-2d25-457d-a131-20ff07cb552b"
|
||||
},
|
||||
{
|
||||
"title": "Differential Diagnosis",
|
||||
"docid": "c18aa6ea-d21c-4e66-af83-4d4b168dc014"
|
||||
},
|
||||
{
|
||||
"title": "Dysmorphic Liver With Abnormal Bile Ducts",
|
||||
"docid": "1cb8d652-5e83-4ee2-a762-bab56e2d107b"
|
||||
},
|
||||
{
|
||||
"title": "Differential Diagnosis",
|
||||
"docid": "5a0f58f1-beb9-459d-8246-83d6ddaf76db"
|
||||
},
|
||||
{
|
||||
"title": "Multiple Hypodense Liver Lesions",
|
||||
"docid": "5178ae9c-1ea9-4e06-9e8a-91e98d8708f6"
|
||||
},
|
||||
{
|
||||
"title": "Biliary Strictures, Multiple",
|
||||
"docid": "7d85bca2-14b8-4a55-8ba4-ded2672122d6"
|
||||
},
|
||||
{
|
||||
"title": "Differential Diagnosis",
|
||||
"docid": "8e572b8d-2fac-4ae9-9781-2cf9398a208f"
|
||||
},
|
||||
{
|
||||
"title": "Differential Diagnosis",
|
||||
"docid": "a8bc808b-8270-46c1-beb4-9c380238e211"
|
||||
}
|
||||
]
|
||||
}
|
||||
},
|
||||
"is_cached": true
|
||||
},
|
||||
{
|
||||
"path": "docs_md/articles/dysmorphic-liver-with-abnormal-bile-ducts_1cb8d652-5e83-4ee2-a762-bab56e2d107b.md",
|
||||
"title": "Dysmorphic Liver With Abnormal Bile Ducts",
|
||||
"docid": "1cb8d652-5e83-4ee2-a762-bab56e2d107b",
|
||||
"breadcrumbs": [
|
||||
"Gastrointestinal",
|
||||
"Differential Diagnosis",
|
||||
"Liver",
|
||||
"Generic Imaging Patterns",
|
||||
"Dysmorphic Liver With Abnormal Bile Ducts"
|
||||
],
|
||||
"authors": [
|
||||
{
|
||||
"key": "6c5a9e0e-9dea-461b-9ad4-c00f5c4c2bbf",
|
||||
"value": "Atif Zaheer, MD, FSAR"
|
||||
},
|
||||
{
|
||||
"key": "e987d3d3-1206-48d6-824b-3347c2968855",
|
||||
"value": "Michael P. Federle, MD, FACR"
|
||||
}
|
||||
],
|
||||
"pageKeywords": "Gastrointestinal, Differential Diagnosis, Liver, Generic Imaging Patterns, Dysmorphic Liver With Abnormal Bile Ducts",
|
||||
"reasons": [
|
||||
"Content"
|
||||
],
|
||||
"snippet": "...## Key Differential Diagnosis Issues - Dysmorphic liver refers to distortion and scarring of parenchyma - May result from inflamma...",
|
||||
"linked_info": {
|
||||
"anatomy": {
|
||||
"exists": false,
|
||||
"links": []
|
||||
},
|
||||
"differential": {
|
||||
"exists": false,
|
||||
"links": []
|
||||
}
|
||||
},
|
||||
"is_cached": true
|
||||
},
|
||||
{
|
||||
"path": "docs_md/articles/biliary-hamartoma_1b525344-ad66-4381-9ca9-3fb11172744f.md",
|
||||
"title": "Biliary Hamartoma",
|
||||
"docid": "1b525344-ad66-4381-9ca9-3fb11172744f",
|
||||
"breadcrumbs": [
|
||||
"Gastrointestinal",
|
||||
"Diagnosis",
|
||||
"Liver",
|
||||
"Benign Neoplasms and Tumor-Like Conditions",
|
||||
"Biliary Hamartoma"
|
||||
],
|
||||
"authors": [
|
||||
{
|
||||
"key": "6c5a9e0e-9dea-461b-9ad4-c00f5c4c2bbf",
|
||||
"value": "Atif Zaheer, MD, FSAR"
|
||||
},
|
||||
{
|
||||
"key": "e987d3d3-1206-48d6-824b-3347c2968855",
|
||||
"value": "Michael P. Federle, MD, FACR"
|
||||
}
|
||||
],
|
||||
"pageKeywords": "Gastrointestinal, Diagnosis, Liver, Benign Neoplasms and Tumor-Like Conditions, Biliary Hamartoma",
|
||||
"reasons": [
|
||||
"Content"
|
||||
],
|
||||
"snippet": "...cal concern - Considered part of spectrum of fibropolycystic disease of liver and kidneys - ### Imaging - Multiple near water-dens...",
|
||||
"linked_info": {
|
||||
"anatomy": {
|
||||
"exists": true,
|
||||
"links": [
|
||||
{
|
||||
"title": "Liver",
|
||||
"docid": "e4fdb09c-d20f-407d-b563-499124541261"
|
||||
},
|
||||
{
|
||||
"title": "Liver",
|
||||
"docid": "236fb145-0c29-4362-be57-06401bf337aa"
|
||||
}
|
||||
]
|
||||
},
|
||||
"differential": {
|
||||
"exists": true,
|
||||
"links": [
|
||||
{
|
||||
"title": "Autosomal Dominant Polycystic Liver Disease",
|
||||
"docid": "c8256fa3-0694-412c-bd0f-8869f336ad90"
|
||||
},
|
||||
{
|
||||
"title": "Hepatic Cyst",
|
||||
"docid": "e525e5da-75e8-432c-b398-cb3d18e97771"
|
||||
},
|
||||
{
|
||||
"title": "Caroli Disease",
|
||||
"docid": "acb4212f-766e-4766-bd10-1ebd525a467c"
|
||||
},
|
||||
{
|
||||
"title": "Hepatic Metastases and Lymphoma",
|
||||
"docid": "248db898-197a-4555-a14d-eef5ca2f8967"
|
||||
},
|
||||
{
|
||||
"title": "Cystic Hepatic Mass",
|
||||
"docid": "85bb9a0b-2d25-457d-a131-20ff07cb552b"
|
||||
},
|
||||
{
|
||||
"title": "Differential Diagnosis",
|
||||
"docid": "c18aa6ea-d21c-4e66-af83-4d4b168dc014"
|
||||
},
|
||||
{
|
||||
"title": "Differential Diagnosis",
|
||||
"docid": "59f30739-548e-4501-96dc-57e48a5386cb"
|
||||
},
|
||||
{
|
||||
"title": "Dysmorphic Liver With Abnormal Bile Ducts",
|
||||
"docid": "1cb8d652-5e83-4ee2-a762-bab56e2d107b"
|
||||
},
|
||||
{
|
||||
"title": "Differential Diagnosis",
|
||||
"docid": "caf98eea-48d6-4a0f-a747-1c162f945fed"
|
||||
},
|
||||
{
|
||||
"title": "Differential Diagnosis",
|
||||
"docid": "6b7939de-9506-4ee2-944d-65766e04e5cf"
|
||||
},
|
||||
{
|
||||
"title": "Differential Diagnosis",
|
||||
"docid": "b93336e2-9006-4f95-92c1-10276069dcc0"
|
||||
},
|
||||
{
|
||||
"title": "Multiple Hypodense Liver Lesions",
|
||||
"docid": "5178ae9c-1ea9-4e06-9e8a-91e98d8708f6"
|
||||
}
|
||||
]
|
||||
}
|
||||
},
|
||||
"is_cached": true
|
||||
},
|
||||
{
|
||||
"path": "docs_md/articles/autosomal-dominant-polycystic-liver-disease_c8256fa3-0694-412c-bd0f-8869f336ad90.md",
|
||||
"title": "Autosomal Dominant Polycystic Liver Disease",
|
||||
@@ -378,11 +608,11 @@
|
||||
"exists": true,
|
||||
"links": [
|
||||
{
|
||||
"title": "Anatomy Document",
|
||||
"title": "Liver",
|
||||
"docid": "e4fdb09c-d20f-407d-b563-499124541261"
|
||||
},
|
||||
{
|
||||
"title": "Anatomy Document",
|
||||
"title": "Liver",
|
||||
"docid": "236fb145-0c29-4362-be57-06401bf337aa"
|
||||
}
|
||||
]
|
||||
@@ -391,7 +621,7 @@
|
||||
"exists": true,
|
||||
"links": [
|
||||
{
|
||||
"title": "Hepatic (Bile Duct) Cysts",
|
||||
"title": "Hepatic Cyst",
|
||||
"docid": "e525e5da-75e8-432c-b398-cb3d18e97771"
|
||||
},
|
||||
{
|
||||
@@ -403,23 +633,23 @@
|
||||
"docid": "acb4212f-766e-4766-bd10-1ebd525a467c"
|
||||
},
|
||||
{
|
||||
"title": "Cystic Metastases",
|
||||
"title": "Hepatic Metastases and Lymphoma",
|
||||
"docid": "248db898-197a-4555-a14d-eef5ca2f8967"
|
||||
},
|
||||
{
|
||||
"title": "Differential Diagnosis",
|
||||
"title": "Cystic Hepatic Mass",
|
||||
"docid": "85bb9a0b-2d25-457d-a131-20ff07cb552b"
|
||||
},
|
||||
{
|
||||
"title": "Differential Diagnosis",
|
||||
"title": "Dysmorphic Liver With Abnormal Bile Ducts",
|
||||
"docid": "1cb8d652-5e83-4ee2-a762-bab56e2d107b"
|
||||
},
|
||||
{
|
||||
"title": "Differential Diagnosis",
|
||||
"title": "Focal Liver Lesion With Hemorrhage",
|
||||
"docid": "5e6be44f-07d3-4569-abe3-798d7513fe41"
|
||||
},
|
||||
{
|
||||
"title": "Differential Diagnosis",
|
||||
"title": "Multiple Hypodense Liver Lesions",
|
||||
"docid": "5178ae9c-1ea9-4e06-9e8a-91e98d8708f6"
|
||||
}
|
||||
]
|
||||
|
||||
@@ -0,0 +1,19 @@
|
||||
[
|
||||
{
|
||||
"label": "'polycistic' (exact)",
|
||||
"queries": [
|
||||
{
|
||||
"qval": "polycistic",
|
||||
"mode": "exact",
|
||||
"targets": [
|
||||
"Title",
|
||||
"Content",
|
||||
"Breadcrumbs",
|
||||
"Keywords",
|
||||
"Category",
|
||||
"Type"
|
||||
]
|
||||
}
|
||||
]
|
||||
}
|
||||
]
|
||||
@@ -252,6 +252,10 @@ def match_author(authors: List[Dict[str, Any]], q: str) -> bool:
|
||||
|
||||
_docid_map = {}
|
||||
|
||||
def clear_doc_cache():
|
||||
global _docid_map
|
||||
_docid_map = {}
|
||||
|
||||
def get_doc_by_id(root: str, identifier: str) -> Tuple[Optional[Dict[str, Any]], Optional[str], Optional[str]]:
|
||||
global _docid_map
|
||||
if not _docid_map:
|
||||
@@ -379,6 +383,7 @@ def check_linked_sections(content: str, root: str = 'docs_md/articles') -> Dict[
|
||||
|
||||
|
||||
def run_search(root: str, qkey: str, qval: str, mode: str = 'exact', targets: List[str] = None, or_queries: List[Dict[str, Any]] = None, expand_links: bool = False) -> List[Dict[str, Any]]:
|
||||
clear_doc_cache()
|
||||
out = []
|
||||
|
||||
# Normalize queries list
|
||||
|
||||
@@ -290,6 +290,37 @@ def search_page() -> None: # build UI
|
||||
|
||||
# Render initial query blocks
|
||||
render_query_blocks()
|
||||
|
||||
# Persistent Search History Container
|
||||
with ui.row().classes('w-full items-center gap-2 mt-2'):
|
||||
ui.label('Recent Searches:').classes('text-slate-400 text-xs font-semibold')
|
||||
history_container = ui.row().classes('gap-1 items-center')
|
||||
|
||||
def render_history_chips():
|
||||
history_container.clear()
|
||||
history = load_history()
|
||||
if not history:
|
||||
with history_container:
|
||||
ui.label('None').classes('text-slate-500 text-xs italic')
|
||||
return
|
||||
with history_container:
|
||||
for item in history[:8]:
|
||||
def make_click(saved=item['queries']):
|
||||
def handler():
|
||||
nonlocal queries
|
||||
queries.clear()
|
||||
for sq in saved:
|
||||
queries.append(json.loads(json.dumps(sq)))
|
||||
render_query_blocks()
|
||||
ui.notify("Search query restored!", type='info')
|
||||
return handler
|
||||
ui.chip(
|
||||
item['label'],
|
||||
clickable=True,
|
||||
on_click=make_click()
|
||||
).props('dense color="slate-800" text-color="blue-300" icon="history"').classes('text-xs hover:bg-slate-700')
|
||||
|
||||
render_history_chips()
|
||||
|
||||
with ui.row().classes('w-full justify-between items-center gap-4 mt-2'):
|
||||
with ui.row().classes('items-center gap-4'):
|
||||
@@ -424,6 +455,61 @@ def search_page() -> None: # build UI
|
||||
table.on('show_links_modal', lambda msg: show_links_modal_handler(msg.args))
|
||||
table.on('capture_article', lambda msg: asyncio.create_task(trigger_capture_handler(msg.args)))
|
||||
|
||||
async def wait_and_process_capture(docid: str, title: str):
|
||||
import glob
|
||||
processed = False
|
||||
for i in range(30):
|
||||
await asyncio.sleep(1.5)
|
||||
|
||||
# Check if JSON files matching the docid exist in input dir
|
||||
json_files = glob.glob(f"xhr_captured_async/*{docid}*.json")
|
||||
if json_files and not processed:
|
||||
with table.client:
|
||||
ui.notify(f"Captured data found for: {title}. Processing to Markdown...", type='info')
|
||||
try:
|
||||
await anyio.to_thread.run_sync(
|
||||
document_to_markdown.main,
|
||||
['--input-dir', 'xhr_captured_async', '--output-dir', 'docs_md']
|
||||
)
|
||||
processed = True
|
||||
except Exception as e:
|
||||
print(f"Error running document_to_markdown: {e}")
|
||||
|
||||
# Check if it has been successfully converted/cached
|
||||
def check_cache():
|
||||
search_md.clear_doc_cache()
|
||||
return search_md.get_doc_by_id('docs_md/articles', docid)
|
||||
fm, content, doc_path = await anyio.to_thread.run_sync(check_cache)
|
||||
|
||||
if fm:
|
||||
# Successfully processed! Reload row data in table!
|
||||
with table.client:
|
||||
row_index = -1
|
||||
for idx, r in enumerate(table.rows):
|
||||
if r.get('docid') == docid:
|
||||
row_index = idx
|
||||
break
|
||||
if row_index != -1:
|
||||
linked_fm_title = fm.get('title') or fm.get('pageTitle') or title
|
||||
updated_row = {
|
||||
'path': doc_path,
|
||||
'title': linked_fm_title,
|
||||
'docid': docid,
|
||||
'breadcrumbs': fm.get('breadcrumbs'),
|
||||
'authors': fm.get('authors'),
|
||||
'pageKeywords': fm.get('pageKeywords'),
|
||||
'reasons': table.rows[row_index].get('reasons', []),
|
||||
'snippet': content[:300] + '...' if content else '',
|
||||
'linked_info': search_md.check_linked_sections(content, root_input.value),
|
||||
'is_cached': True
|
||||
}
|
||||
table.rows[row_index] = updated_row
|
||||
table.rows = list(table.rows)
|
||||
ui.notify(f"Successfully cached and loaded: {linked_fm_title}!", type='positive')
|
||||
else:
|
||||
ui.notify(f"Cached document: {title}", type='positive')
|
||||
return
|
||||
|
||||
async def trigger_capture_handler(args: dict):
|
||||
docid = args.get('docid')
|
||||
title = args.get('title')
|
||||
@@ -439,11 +525,15 @@ def search_page() -> None: # build UI
|
||||
except Exception:
|
||||
return False
|
||||
|
||||
def start_capture_poll_task(d_id, t_title):
|
||||
asyncio.create_task(wait_and_process_capture(d_id, t_title))
|
||||
|
||||
with table.client:
|
||||
ui.notify(f"Checking capture browser status for: {title}...", type='info')
|
||||
ok = await asyncio.to_thread(check_and_send)
|
||||
if ok:
|
||||
ui.notify(f"Requested capture browser to open: {title}", type='positive')
|
||||
start_capture_poll_task(docid, title)
|
||||
return
|
||||
|
||||
ui.notify("Capture browser not responding. Cleaning up existing capture processes...", type='warning')
|
||||
@@ -465,6 +555,7 @@ def search_page() -> None: # build UI
|
||||
ok_again = await asyncio.to_thread(check_and_send)
|
||||
if ok_again:
|
||||
ui.notify(f"Capture browser launched successfully. Opened: {title}", type='positive')
|
||||
start_capture_poll_task(docid, title)
|
||||
else:
|
||||
ui.notify("Capture browser process launched, but command port timed out. Try clicking again in a few seconds.", type='warning')
|
||||
except Exception as e:
|
||||
@@ -738,6 +829,20 @@ def search_page() -> None: # build UI
|
||||
status.set_text('Running search...')
|
||||
search_btn.set_enabled(False)
|
||||
|
||||
# Save query configuration to persistent history
|
||||
active_queries = [q for q in queries if q['qval'].strip()]
|
||||
if active_queries:
|
||||
history_label = " OR ".join([f"'{q['qval']}' ({q['mode']})" for q in active_queries])
|
||||
history_item = {
|
||||
'label': history_label,
|
||||
'queries': json.loads(json.dumps(queries))
|
||||
}
|
||||
history = load_history()
|
||||
history = [h for h in history if h['label'] != history_label]
|
||||
history.insert(0, history_item)
|
||||
save_history(history[:20])
|
||||
render_history_chips()
|
||||
|
||||
try:
|
||||
or_queries_param = []
|
||||
for q in queries:
|
||||
@@ -984,6 +1089,25 @@ def linkify_references(content: str, root: str = 'docs_md/articles') -> str:
|
||||
return content
|
||||
|
||||
|
||||
HISTORY_FILE = 'search_history.json'
|
||||
|
||||
def load_history() -> list:
|
||||
try:
|
||||
if os.path.exists(HISTORY_FILE):
|
||||
with open(HISTORY_FILE, 'r', encoding='utf-8') as f:
|
||||
return json.load(f)
|
||||
except Exception:
|
||||
pass
|
||||
return []
|
||||
|
||||
def save_history(history_list: list):
|
||||
try:
|
||||
with open(HISTORY_FILE, 'w', encoding='utf-8') as f:
|
||||
json.dump(history_list, f, indent=2, ensure_ascii=False)
|
||||
except Exception:
|
||||
pass
|
||||
|
||||
|
||||
def is_doc_cached(docid: str) -> bool:
|
||||
fm, _, _ = search_md.get_doc_by_id('docs_md/articles', docid)
|
||||
return fm is not None
|
||||
|
||||
Reference in New Issue
Block a user