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[10] Other procedures associated with ERCP include the trawling of the common bile duct with a basket or balloon to remove gallstones and the insertion of a plastic stent to assist the drainage of bile. [11] Also, the pancreatic duct can be cannulated and stents be inserted. The pancreatic duct requires visualisation in cases of pancreatitis.
Papillary stenosis is a disturbance of the sphincter of Oddi, a muscular valve, that prevents the opening and release of bile or pancreatic fluids into the duodenum in response to food entering the duodenum. Obstruction of the valve can cause: pancreatic pain; jaundice – bile leaking back into the blood stream. attacks of pancreatitis
biliary dyskinesia; ICD-10 code K83: other diseases of the biliary tract: cholangitis (including ascending cholangitis and primary sclerosing cholangitis) obstruction, perforation, fistula of biliary tract (bile duct) spasm of sphincter of Oddi; biliary cyst; biliary atresia
This is a shortened version of the ninth chapter of the ICD-9: Diseases of the Digestive System. It covers ICD codes 520 to 579. The full chapter can be found on pages 301 to 328 of Volume 1, which contains all (sub)categories of the ICD-9. Volume 2 is an alphabetical index of Volume 1.
In chronic pancreatitis, these tests may be normal. [1] Medical imaging such as ultrasound and CT scan may also be useful. [1] Acute pancreatitis is usually treated with intravenous fluids, pain medication, and sometimes antibiotics. [1] Typically eating and drinking are disallowed, and a nasogastric tube is placed in the stomach. [1]
In patients with PBM, regardless of the presence of biliary dilatation, acute pancreatitis is more common in children (30% of patients) than in adults (9%). [7] Although pancreatitis is often mild with subtle imaging findings, it can also be recurrent. [8] One possible cause of acute pancreatitis linked to PBM is protein plugs. [9]
Jaundice of the skin or eyes is an important physical finding in biliary obstruction. Jaundice and/or clay-colored stool may raise suspicion of choledocholithiasis or even gallstone pancreatitis. [1] If the above symptoms coincide with fever and chills, the diagnosis of ascending cholangitis may also be considered.
Besides providing information regarding the biliary system, MRCP also provides information regarding surrounding solid organs and blood vessels, thus useful for planning the resection of pancreatic cancer and look for complications of primary sclerosing cholangitis such as liver cirrhosis and cholangiocarcinoma. [5]