Endoscopic Ultrasound in Biliary Colic

Abstract

Biliary sludge is seen on ultrasound as an amorphous echogenic material, which slowly moves to the dependent part. Endoscopic ultrasound has a sensitivity of 96% to detect biliary sludge, and the appearance is similar to that seen on transabdominal ultrasound. Other entities which can have a similar appearance include blood, pus, necrotic debris, and multiple small stones. This case represents a unique finding on endoscopic ultrasound of an echogenic image in CBD, mimicking biliary sludge.

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References

  1. 1.

    Wang HH, Portincasa P, Liu M, Tso P, Wang DQ-H (2018) Similarities and differences between biliary sludge and microlithiasis: their clinical and pathophysiological significances. Liver Res 2(4):186–199

    Article  Google Scholar 

  2. 2.

    Bergele C, Giovannini M (2004) EUS and common bile duct stones. Ann Gastroenterol 17(3):246–252

    Google Scholar 

  3. 3.

    Varghese JC, Liddell RP, Farrell MA, Murray FE, Osborne DH, Lee MJ (1999) The diagnostic accuracy of magnetic resonance cholangiopancreatography and ultrasound compared with direct cholangiography in the detection of choledocholithiasis. Clin Radiol 54:604–614

    Article  CAS  Google Scholar 

  4. 4.

    Scheiman J, Carlos R, Barnett J et al (2001) Can endoscopic ultrasound or magnetic resonance cholangiopancreatography replace ERCP in patients with suspected biliary disease? A prospective trial and cost analysis EUS versus MRCP for suspected biliary disease. Am J Gastroenterol 96:2900–2904

    Article  CAS  Google Scholar 

  5. 5.

    Kamaya A, Wong-You-Cheong J, Woodward PJ (2019) Diagnostic ultrasound for sonographers E-Book. Elsevier Health Sciences. P 51

  6. 6.

    Kim CW, Chang JH, Lim YS, Kim TH, Lee IS, Han SW (2013) Common bile duct stones on multidetector computed tomography: attenuation patterns and detectability. World J Gastroenterol 19(11):1788–1796

    Article  Google Scholar 

  7. 7.

    Dittrick G, Lamont JP, Kuhn JA, Mallat D (2005) Usefulness of endoscopic ultrasound in patients at high risk of choledocholithiasis. Proc (Baylor Univ Med Cent) 18(3):211–213

    Article  Google Scholar 

  8. 8.

    Rana SS, Bhasin DK, Rao C, Singh K (2012) Role of endoscopic ultrasound in idiopathic acute pancreatitis with negative ultrasound, computed tomography, and magnetic resonance cholangiopancreatography. Ann Gastroenterol 25(2):133–137

    PubMed  PubMed Central  Google Scholar 

  9. 9.

    Sajith KG, Chacko A, Dutta AK (2010) Recurrent acute pancreatitis: clinical profile and an approach to diagnosis. Dig Dis Sci 55:3610–3616

    Article  CAS  Google Scholar 

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Correspondence to Amit Soni.

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The manuscript has been read and approved by the authors. It is original and honest work. The manuscript has not been published previously and is not currently under consideration for publication elsewhere. In case of acceptance of the manuscript the copyright is transferred to your journal. There is no financial or other relationships that might lead to a conflict of interest.

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Soni, A., Nagpal, S. & Mittal, A. Endoscopic Ultrasound in Biliary Colic. Indian J Surg (2020). https://doi.org/10.1007/s12262-020-02509-z

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Keywords

  • Endoscopic ultrasound
  • Biliary sludge
  • Cholangitis
  • Idiopathic pancreatitis