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Abstract

Liver, gallbladder, and pancreatic diseases, all of which are related to the diagnosis of jaundice, have already been discussed. Ultrasound examination of the jaundiced patient proceeds in a logical fashion. The first step is to decide whether there is dilatation of the biliary tree. Dilatation may exist at the level of the common bile duct, the common hepatic duct, the convergence of the right and left hepatic ducts, the intrahepatic bile ducts, or the gallbladder. The second step is to identify the exact level of obstruction, and, if possible, the obstructing lesion.

Keywords

Bile Duct Portal Vein Common Bile Duct Hepatic Artery Obstructive Jaundice 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

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References and Further Reading

  1. Abdeselem K, Hassine W, Gharbi HA (1982) Complications biliaires du kyste hydatique du foie. Méd Chir Dig 11: 189–191Google Scholar
  2. Bamett E, Morley P (1974) Abdominal echography. Butter- worth, Borough Green, EnglandGoogle Scholar
  3. Baron RL, Stanley RJ, Lee JKT, Koehler RE, Melson GL, Belfe DM, Weyman PJ (1982) A prospective comparison of the evaluation of biliary obstruction using computed tomography and ultrasonography. Radiology 145: 91–98PubMedGoogle Scholar
  4. Berk RN, Cooperberg PL, Gold RP, Rohrmann CA, Ferrucci JT (1982) Radiography of the bile ducts. Radiology 145:1–9PubMedGoogle Scholar
  5. Bismuth H, Housin D (1978) Economie de moyens dans le diagnosdc des ictères: atdtude décisionnelle contre attitude diagnostique. Nouv Presse Méd 7 (26): 2629–2833PubMedGoogle Scholar
  6. Bolondi L, Gandolfi L, Labo G (1979) Ultrasuoni in gastroenterologia. Piccin Editore, PaduaGoogle Scholar
  7. Brauner M, Gastinne R, Hassan M (1985) Analyse conjointe de l’échographie et de la biologie dans les dilatations des voies bilaires. J Radiol 66 (8–9): 515–518PubMedGoogle Scholar
  8. Conrad MR, Landay MJ, Janes JO (1978) Sonographic “parallel channel” sign of biliary tree enlargement in mild to moderate obstruction jaundice. AJR 130: 279–286PubMedGoogle Scholar
  9. Cooperberg PL, Li D, Wong P, Cohen MM, Burhenne HJ (1980) Accuracy of common hepatic duct size in the evaluation of extrahepatic biliary obstruction. Radiology 135: 141–144PubMedGoogle Scholar
  10. Cosgrove DO, Dunn F (1976) Ultrasonic differentiation between blood and bile vessels in the liver. Proceedings of the world federation of ultrasound in medicine and biology. American Institute for Ultrasound in Medicine, San Francisco, abstract no 551Google Scholar
  11. Cronan JJ (1986) US diagnosis of choledocholithiasis: a reappraisal. Radiology 161: 133–134PubMedGoogle Scholar
  12. Cronan JJ, Mueller PR, Simeone JF, O’Connell RS, Van Sonnenberg E, Wittenberg J, Ferrucci JT (1983) Prospective diagnosis of choledocholithiasis. Radiology 146: 467–469PubMedGoogle Scholar
  13. Cunningham JJ, Carswell EL (1982) Strong acoustical shadowing from the gallbladder bed: ultrasonic-pathologic correlation. Gastrointest Radiol 7: 367–369PubMedCrossRefGoogle Scholar
  14. Dalla-Palma L, Rizzatto G, Bazzocchi M, Pozzi-Mucelli RS Grey-scale ultrasonography in the evaluation of primary carcinomas of the bile ducts. Eur J Radiol 2: 135Google Scholar
  15. Eisenscher A, Sauget Y (1980) Aspect ultrasonore des asca- ridioses et distomatoses des voies biliaires. J Radiol 61 (5): 319–322PubMedGoogle Scholar
  16. Ethier S, Fontaine A (1980) L’image de la tourelle. Un signe échographique utile dans l’obstruction biliaire basse. Union Med Can 109: 1204–1206PubMedGoogle Scholar
  17. Ethier S, Fontaine A, Laperriere J, Grégoire A, Boisjoli A, Magnan F (1980) Séméiologie ultrasonore de l’ictère par rétention. Union Méd Can 109: 1–6Google Scholar
  18. Ferruci JT, Adson MA, Mueller PR, Stanley RJ, Stewart ET (1983) Advances in the radiology of jaundice. A symposium and review. AJR 141: 1–20Google Scholar
  19. Filly R (1982) Artifacts in ultrasound. Leading edge in ultrasound 5th May 1982, Adantic CityGoogle Scholar
  20. Floyd JL, Collins TL (1982) Discordance of sonography and cholescintigraphy in acute biliary obstruction. AJR 140:501–502Google Scholar
  21. Gibson RN, Young F, Thompson JN, Carr DH, Hemingway AP, Bradpiece HA, Benjamin IS, Blumgart LH, Allison DJ (1986) Bile duct obstruction: radiologic evaluation of level, cause, and tumor resectability. Radiology 160: 43–47PubMedGoogle Scholar
  22. Ginestal-Cruz A, Correia JP, Camilo E, Grima N, Cardoso A, Baptista A, Gargate A, Ribeiro JC, Lacerda A (1981)Combined approach to the differential diagnosis of cholestatic jaundice with endoscopic retrograde cholangiopancreatography, percutaneous transhepatic cholangiography, ultrasonography, and liver biopsy. Gastrointest Radiol 6: 177–183PubMedCrossRefGoogle Scholar
  23. Glazer GM, Filly RA, Laing FC (1981) Rapid change in caliber of the nonobstructed duct. Radiology 140:161–162PubMedGoogle Scholar
  24. Goldberg BB (1976) Ultrasonic cholangiography gray scale B-scan evaluation of the common bile duct. Radiology 118:400–404Google Scholar
  25. Gross BH, Harter LP, Gore RM, Callen PW, Filly RA, Shapiro HA, Goldberg HI (1983) Ultrasonic evaluation of common bile duct stones: prospective comparison with endoscopic retrograde cholangiopancreatography. Radiology 146: 471–474PubMedGoogle Scholar
  26. Hadidi A (1982) Normal and obstructed main bile duct evaluated by a modified ultrasound technique. Acta Radiol [Diagn] (Stockh) 23 (1): 37–41Google Scholar
  27. Hadidi A (1983) Ultrasonic diagnosis of primary intraductal cholelith and Neoplasm. Gastrointest Radiol 8: 333–336PubMedCrossRefGoogle Scholar
  28. Hoevels J (1978) Topographic relation of portal vein to extrahepatic bile ducts. Fortschr Roentgenstr 129 (2): 217–222CrossRefGoogle Scholar
  29. Holm HH, Kristensen JK, Rasmussen SN, Pedersen JF, Hancke S (1980) Abdominal ultrasound, 2nd edn. Munksgaard, CopenhagenGoogle Scholar
  30. Janus C, Hertz I, Homer N, Waye J (1982) Diagnostic retrospective in pancreaticobiliary imaging: ultrasound and ERCP. Gastrointest Radiol 7: 363–365PubMedCrossRefGoogle Scholar
  31. Koenigsberg M, Wiener SN, Walzer A (1979) The accuracy of sonography in the differential diagnosis of obstructive jaundice: a comparison with cholangiography. Radiology 133: 157–165PubMedGoogle Scholar
  32. Laing FC, Jeffrey RB (1983) Choledocholithiasis and cystic duct obstruction: difficult ultrasonographic diagnosis. Radiology 146: 475–479PubMedGoogle Scholar
  33. Laing FC, Jeffrey RB, Wing VW, Nyberg DA (1986) Biliary dilatation: defining the level and cause by real-time US. Radiology 160: 39–42PubMedGoogle Scholar
  34. Lammer J, Neumayer K (1986) Biliary drainage endoprostheses: experience with 201 placements. Radiology 159: 625–629PubMedGoogle Scholar
  35. Lee JKT, Melson GL (1979) Unusual sonographic appearance of a Courvoisier gallbladder. Radiology 7/8: 93- 94Google Scholar
  36. Leopold GR, Asher WM (1975) Fundamentals of abdominal and pelvic ultrasonography. Saunders, PhiladelphiaGoogle Scholar
  37. Levine E, Maklad NF, Wright CH, Lee KR (1979) Computed tomographic and ultrasonic appearances of primary carcinoma of the common bile duct. Gastrointest Radiol 4: 147–151PubMedCrossRefGoogle Scholar
  38. Makuuchi M, Bandai Y, Ito T, Watanabe G, Wada T, Abe H, Muroi T (1980) Ultrasonically guided percutaneous transhepatic bile drainage. Radiology 136: 165–169PubMedGoogle Scholar
  39. Metreweli C (1982) Abdominal sonopediatrics, 7th International Course “Ultrasound in Besançon” 1982, BesançonGoogle Scholar
  40. Mueller PR, Cronan JJ, Simeone JF, van Sonnenberg E, Hall DA (1983) Choledocholithiasis: Ultrasonographic caveats. J Ultrasound Med 2: 13–16Google Scholar
  41. Pedersen JH, Christensen RF, Juul N, Burcharth F (1985) Comparison of ultrasonography and transhepatic cholangiography in the evaluation of obstructive jaundice. Fortschr Röntgenstr 143 (1): 41–43CrossRefGoogle Scholar
  42. Perimutter GS, Goldberg BB (1975) Ultrasonic evaluation ofthe common bile duct. J Clin Ultrasound 4: 107–111CrossRefGoogle Scholar
  43. Phillips G, Banks S, Kumari-Subaiya S, Kurtz LM (1982) Percutaneous ultrasound-guided puncture of the gallbladder. Radiology 145: 769–772PubMedGoogle Scholar
  44. Ralls PW, Quinn MF, Halls J (1981) Biliary sonography: Ventral bowing of the dilated common duct. AJR 137: 1127–1129Google Scholar
  45. Sidharta H, Brotohusodo J, Sjahli D (1985) The value of ultrasonography in obstructive jaundice. 5th Worid congress of ultrasound (WFUMB), July 1985, Sydney, abstract p 131Google Scholar
  46. Simeone JF, Mueller PR, Ferrucci JT et al. (1982) Sonography of the bile ducts after a fatty meal: an aid in detection of obstruction. Radiology 143: 211–215PubMedGoogle Scholar
  47. Simeone JF, Butch RJ, Mueller PR, Van Sonnenberg E, Ferrucci JT Jr, Hall DA, Kopans DB, Dawson SL, Wittenberg J, McCarthy K (1985) The bile ducts after a fatty meal: further sonographic observations. Radiology 154: 763–768PubMedGoogle Scholar
  48. Stone LB, Ferrucci JT Jr, Warshaw AL, Wittenberg J, Slut- sky M (1975) Gray scale ultrasound diagnosis of obstructive biliary disease. AJR 125: 47–50Google Scholar
  49. Subramanyam BR, Balthazar EJ, Naidich DP (1983) Ruptured hydatid cyst with biliary obstruction: diagnosis by sonography and computed tomography. Gastrointest Radiol 8: 341–343PubMedCrossRefGoogle Scholar
  50. Suzuki M, Takashima T, Funaki H et al. (1983) CT diagnosis of common bile duct stone. Gastrointest Radiol 8: 327–331PubMedCrossRefGoogle Scholar
  51. Taylor JW (1979) Diagnostic ultrasound in gastrointestinal disease. Livingstone, Edinburgh Taylor KJW, Carpenter DA, McCready VR (1974) Ultrasound and scintigraphy in the differential diagnosis of obstructive jaundice. J Clin Ultrasound 2: 105–115CrossRefGoogle Scholar
  52. Weill F (1977) Ultrasonographic digestive abdominale. Encycl Méd Chir Radiodiagnostic IV, fase 33506 E 10: 85Google Scholar
  53. Weill F, Gisselbrecht H, Ricatte JP, Kraehenbuhl JR, Schraub S, Becker JC (1971) Diagnostic tomo-échogra- phique des dilatations vésiculaires. Arch Fr Mai App Dig 60: 49–54Google Scholar
  54. Weill F, Becker JC, Kraehenbuhl JR, Heriot G, Walter JP (1973) Atlas clinique de radiographic ultrasonore. Mas- son, ParisGoogle Scholar
  55. Weill F, Bourgoin A, Aucant D, Eisenscher A, Faivre M, Gillet M (1974) L’exploration tomo-échographique des dilatations de la voie biliaire principale. Sa place dans le bilan radiologique d’un ictère. Arch Fr Mal App Dig 63: 453–472PubMedGoogle Scholar
  56. Weill F, Eisenscher A, Zeltner F (1978 a) Ultrasonic study of the normal and dilated biliary tree. The shotgun sign. Radiology 12: 221–224Google Scholar
  57. Weill F, Marmier A, Paronneau P, Zeltner F, Charton MN (1978 b) Diagnostic ultrasonore des ictères, 199 malades. Nouv Presse Méd 7/41: 3729–3731Google Scholar
  58. Weill F, Marmier A, Paronneau P, Zeltner F, Rohmer P (1979) Etude ultrasonore des ictères. Séméiologie. Résultats à propos de 199 cas. J Radiol 59: 659–668Google Scholar
  59. Weinstein BJ, Weinstein DP (1980) Biliary tract dilatation in the nonjaundiced patient. AJR 134: 899–906PubMedGoogle Scholar
  60. Zeman R, Taylor KJW, Burrel MI, Gold J (1980) Ultrasound demonstration of an icteric dilatation of the biliary tree. Radiology 134: 689–692 Zeman RK, Lee C, Stahl RS et al. (1982) Ultrasonography and hepatobiliary scintigraphy in the assessment of biliary-enteric anastomoses. Radiology 145: 109–115Google Scholar
  61. Zeman RK, Burrell MI, Dobbins J, Jaffe MH, Choyke PL (1985) Postcholecystectomy syndrome: evaluation using biliary scintigraphy and endoscopic retrograde cholangiopancreatography. Radiology 156: 787–792PubMedGoogle Scholar

Copyright information

© Springer-Verlag Berlin Heidelberg 1990

Authors and Affiliations

  • Francis S. Weill
    • 1
  1. 1.Chaire de RadiodiagnosticRadiologie A Hôpital Jean MinjozBesançonFrance

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