Giant duodenal diverticulum - A cause of false-positive findings of magnetic resonance imaging cholangiopancreatography, and hepatobiliary scintigraphy

A 68-year-old woman with a long history of eructations was referred for hepatobiliary and magnetic resonance cholangiopancreatography (MRCP) 3 years after cholecystectomy. Results of upper gastrointestinal endoscopy and biochemical investigations were within normal limits. Hepatobiliary scintigraphy showed large photopenic liver defects on initial images and filling with radio-activity subsequently, suggestive of Caroli's disease or biliomas. MRCP corroborated in showing a large bile collection in the middle of the right lobe of the liver and surrounded by multiple collections. Later, a barium meal follow-through test revealed that these were parts of a large duodenal diverticulum branching out into the liver parenchyma.