Jorge Arturo Hernandez is a General Surgeon and Member of the Mexican Association of General Surgery, certified by the Mexican Council of General Surgery. He is an Endoscopist in the 2nd year of training and also a Member of the Mexican Association of Phlebology and Lymphology.
Multiple biliary hamartomatosis or Meyenburg Complex was described in 1918 and consists of a deformation and disorganization of the bile ducts, forming cystic structures that vary in size. An incidence of 5.6% in adults and 0.9% in children is reported. The diagnosis of this disease has gone very far thanks to the technological advances of imaging. Previously the management was conservative, maintaining an expectant and continuous periodic behavior, however, at present, the increase in the number of cases, that there is a possible association with the development of cholangiocarcinoma. The treatment for isolated and unique lesions is surgical resection whenever is possible. A 56 years female without risk factors, controlled hypertension, without allergic or surgical history, assigned to the outpatient clinic with hepatobiliary ultrasound that reports hypoechoic, multiple images in the hepatic parenchyma, gallbladder and extrahepatic bile duct without alterations, the intrahepatic bile duct with multiple ectasias that deform the gland. It is protocolized for primary tumor search thinking about metastatic disease, basic paraclinical without alterations, liver function tests without alterations, normal tumor markers, normal panndoscopy and colonoscopy. Magnetic cholangiography is performed, which in T2 sequence shows multiple hyperintense images, alternating with areas of low signal uptake and in spin echo sequence with T2 reinforcement hyperintense images are identified coinciding with cystic lesions that cover more than 90% of the hepatic gland. Multiple biliary hamartomatosis had been considered and managed as benign behavior pathology, however, experience, technological progress and its relationship with the development of cholangiocarcinoma makes us question the need to consider its surgical treatment, including liver transplantation.