Radiology, Vol 138, 129-136, Copyright © 1981 by Radiological Society of North America
Disparate dilatation of the intrahepatic and extrahepatic bile ducts in surgical jaundice
RK Zeman, GS Dorfman, MI Burrell, S Stein, GR Berg and JA Gold
Intrahepatic biliary dilatation on ultrasound has been reported as an early
sign of biliary obstruction. This paper reports 12 patients with
extrahepatic biliary obstruction in whome the extrahepatic biliary system
was increased in caliber despite a normal appearance of the intrahepatic
ducts. The bile ducts in all of these patients were evaluated with
ultrasound and percutaneous transhepatic cholangiography. Computed
tomography was performed in one case. The causes of obstructive jaundice
included stricture, choledocholithiasis, and neoplasm. The common bile duct
provides a sensitive indicator of biliary obstruction, and its
demonstration by noninvasive or invasive means is mandatory even when the
intrahepatic ducts appear to be normal.
