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English: Elective abdominal ultrasonography of a 64 year old woman with past colicky pain but no current pain. It shows a mildly dilated common bile duct with what appears to be a gallstone (black arrow). The green and blue dots are blood flow, since the exam is done as a Doppler ultrasound to distinguish the bile duct from blood vessels.
The double duct sign is a radiological finding characterized by the simultaneous dilation of the common bile duct and the main pancreatic duct.This sign is significant because it often indicates an obstruction in the distal bile duct and pancreatic duct, frequently caused by serious underlying pathologies such as pancreatic carcinoma or periampullary tumors. [1]
The bile duct is some 6–8 cm long, and normally up to 8 mm in diameter. [4]Its proximal supraduodenal part is situated within the free edge of the lesser omentum.Its middle retroduodenal part is oriented inferiorly and right-ward, and is situated posterior to the first part of the duodenum, and anterior to the inferior vena cava.
Ultrasound image showing the liver, gallbladder and common bile duct. Medical ultrasound uses high frequency broadband sound waves in the megahertz range that are reflected by tissue to varying degrees to produce (up to 3D) images. This is commonly associated with imaging the fetus in pregnant women. Uses of ultrasound are much broader, however.
Common bile duct stone, also known as choledocholithiasis, is the presence of gallstones in the common bile duct (CBD) (thus choledocho-+ lithiasis). This condition can cause jaundice and liver cell damage. Treatments include choledocholithotomy and endoscopic retrograde cholangiopancreatography (ERCP).
A surgically created passage between the common bile duct and the jejunum in a procedure called a choledochojejunostomy, can be carried out to relieve the symptoms of biliary obstruction as well as allows the bile duct to drain. [5] In infants with biliary atresia, hepatoportoenterostomy is an alternative method of providing bile drainage.
Obstruction of the common bile duct with gallstones can sometimes be relieved by endoscopic retrograde sphincterotomy (ERS) following endoscopic retrograde cholangiopancreatography (ERCP). [54] Risks of ERCP. [55] Surgery carries risks and some people continue to experience symptoms (including pain) afterwards, for reasons that remain unclear.
Fluoroscopic image of common bile duct stone seen at the time of ERCP. The stone is impacted in the distal common bile duct. A nasobiliary tube has been inserted. Fluoroscopic image showing dilatation of the pancreatic duct during ERCP investigation. Endoscope is visible. Obstructive jaundice – This may be due to several causes
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