Computed tomography and obstructive biliary disease

A prospective study of 33 patients with cholestatic jaundice was performed with combined use of endoscopic retrograde cholangiopancreatography (ERCP), percutaneous transhepatic cholangiography (PTC), ultrasonography, and liver biopsy. A higher rate of success with PTC in 25 cases of extrahepatic cholestasis was offset by the better score of ERCP in 8 cases of intrahepatic cholestasis and its wider diagnostic scope. The procedures were complementary in 10 cases. Ultrasonic imaging of intrahepatic bile ducts proved useful for selecting the first cholangiographic technique. Liver biopsy established etiology in intrahepatic cholestasis. Our combined approach allowed us to develop through objective criteria a diagnostic flow chart of cholestasis.

mentioning

confidence: 99%

Combined approach to the differential diagnosis of cholestatic jaundice with endoscopic retrograde cholangiopancreatography, percutaneous transhepatic cholangiography, ultrasonography, and liver biopsy

Ginestal-Cruz

Pinto-Correia

Camilo

et al. 1981

“…Dilatation of the intrahepatic biliary system points to the presence of an obstructing lesion and is well demonstrated by both methods. Furthermore, these techniques frequently reveal the nature of the obstructing lesion [4][5][6][7][8]. However, not all patients with obstructive jaundice show such a clearcut pattern.…”

Section: Discussionmentioning

confidence: 99%

Computed tomographic and ultrasonic appearances of primary carcinoma of the common bile duct

Levine

Maklad

Wright

et al. 1979

Two patients with obstructive jaundice due to surgically proved primary carcinoma of the common bile duct were examined by CT and ultrasound. The combination of the two modalities showed dilatation of the extrahepatic biliary system and the main pancreatic duct. The diagnosis of primary bile duct carcinoma is suggested by these findings in the presence of a normal pancreatic head, although similar findings may occur with a small pancreatic or ampullary carcinoma.

“…The walls of the gallbladder appear thickened and the overall size of the gallbladder is usually contracted, although it may be of normal size. Rarely, thickening o f the gallbladder wall may be seen by CT [11].…”

Section: Cholecystitismentioning

confidence: 99%

Hepatobiliary disease: A comparative evaluation by ultrasound and computed tomography

Raskin

1978

Ultrasound and computed tomography (CT) are both relatively new techniques for evaluating gallbladder and biliary disease. Ultrasound is more sensitive than CT for detecting the presence of gallstones because of partial volume averaging errors which occur with CT. Both modalities are sensitive methods of differentiating jaundice due to intrahepatic disease from extrahepatic obstruction. However, CT should not be considered a screening test at the present time and should be reserved for selected cases where ultrasound is unable to produce diagnostically acceptable information.