Terms in this set (7)
stone is the bile duct
incidence of choledocholithiasis
higher in middle aged males and in people with ulcerative colitis
common sites of bile duct stones ( choledocholithiasis)
1.distal CBD, 2. hepatic ducts, 3. then cystic ducts
difficulties when imaging choledocholithiasis
CBD is deep and prevents use of very high frequency, gas pockets, relfectionand refraction of the beam, CBD outside focal zone, too little fluid around the stone
things to try when having diffuculty visualizing a cbd stone
Water Study (Helps visualize stones near duodenumTrendelenburg-pools bile around the stone.Higher frequency -makes shadows more visible.
Structures That Mimic Choledocholithiasis
1. Air or residue in adjacent bowel that mimics a stone. 2. RHA crossing the CBD and indenting it. 3. Postoperative cholecystectomyclips. 4. Impression on the CBD by the Cystic Duct. 5. Air in the biliarytree. 6. mucus plug 7. Calcification in the head of the pancreas
Disease Process of choledocholithiasis
Recurrent Bile duct inflammation with bouts of fever, pain and jaundice. 2. Periportalspaces and hepatic parenchyma are infiltrated with inflammatory cells 3. Periportalfibrosis and bile duct strictures occur causing dilated bile ducts, formation of ductalstones, local hepatic necrosis and possibly abscess 4. Recurrent cholangitisand cholangiocarcinomaare related.
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Bile Duct Pathology
congenital anomalies of the biliary tree