Von Meyenburg Complex Presenting with Cholangitis-Like Condition Picture: A Case Report
Abstract
Objective: Von Meyenburg Complex (VMC) is a benign biliary malformation that can mimic severe hepatobiliary pathologies. This report evaluates a symptomatic VMC case presenting with high inflammatory markers, highlighting the diagnostic challenge in differentiating it from true bacterial cholangitis or hepatic abscess.
Case Report: A 58-year-old male presented with abdominal pain, chills, and vomiting. Notably, the patient was anicteric and did not fulfill the complete Charcot’s triad. Laboratory results showed marked elevation of CRP (156 mg/L) and ESR (51 mm/h), while blood cultures remained negative. Radiographic findings initially suggested hepatic abscesses or periportal inflammation. However, histopathological analysis revealed no purulent material, showing only VMC-related features and chronic inflammation. The patient’s clinical improvement after broad-spectrum antibiotic therapy suggests an inflammatory process likely triggered by bile stasis within the hamartomatous ducts.
Conclusion: In VMC patients, high inflammatory markers and “abscess-like” imaging can occur without overt suppuration or biliary obstruction. Clinicians should maintain VMC in the differential diagnosis even when clinical findings mimic infectious cholangitis to avoid misdiagnosis of malignancy or unnecessary surgical intervention.
Keywords
Von Meyenburg complex, Biliary hamartoma, Cholangitis, MRCP, Liver biopsy, Tokyo guidelines 2018, Systemic inflammation
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