Imaging in biliary obstruction

doi:10.1136/bmj.329.7464.501

BMJ 2004;329:501 (28 August), doi:10.1136/bmj.329.7464.501

Commentary

Imaging in biliary obstruction

Adrian M K Thomas, consultant radiologist¹

¹ Department of Nuclear Medicine, Princess Royal University Hospital, Orpington, Kent BR6 8ND adrian.thomas@btinternet.com

The first 150 words of the full text of this article appear below.

Mrs Prior was referred for ultrasonography after identificationof abnormal liver function.¹ Imaging of the liver and biliarytree is a common problem, and advances in ultrasonography, computedtomography, and magnetic resonance imaging have improved ourdiagnostic ability.² Ultrasonography is the first investigationfor suspected biliary disease. This patient's scan showed stonesin the gall bladder and in the lower common bile duct. Ultrasonographyshould be available with only a short wait for more urgent cases.

Her biliary tree is dilated with intrahepatic and extrahepaticbiliary dilatation, and the common bile duct measured 11 mm.In over 95% of healthy people the diameter of the common bileduct is less than 4 mm. In patients with gall stones it canmeasure up to 7 mm without implying obstruction. The commonbile duct can also dilate in elderly people secondary to degenerationin the ductal wall, reaching diameters of up to . . . [Full text of this article]

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