Bile duct dilatation (differential)

Bile duct dilatation can occur from a number of etiologies.

Variable, depending on underlying cause, but usually:

  • right upper quadrant pain
  • jaundice
Ultrasound

Harmonic imaging is useful when assessing the biliary system,as it improves the clarity of the lumen.

  • intrahepatic bile ducts
    • >2 mm
    • >40% of adjacent portal vein
  • extrahepatic bile ducts (common hepatic duct and common bile duct)
    • usually measured in the proximal duct, near the hepatic artery
    • diameter measured from inner wall to inner wall
    • >6 mm +1 mm per decade above 60 years of age
    • >10 mm post-cholecystectomy

Focal dilatation may be a result of downstream stricture, or damage to the elasticity of that segment of bile duct, possibly from prior stone passage.

Colour Doppler can be useful to ensure that dilated structures in the liver are actually bile ducts and not an intrahepatic vascular malformation.

The second thing to establish is which part of the biliary system is dilated:

  • intrahepatic
  • extrahepatic
  • intrahepatic and extrahepatic
Intrahepatic biliary dilatation only
Extrahepatic biliary dilatation only
Intrahepatic and extrahepatic biliary dilatation
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Article Information

rID: 34179
Section: Gamuts
Synonyms or Alternate Spellings:
  • Biliary ductal dilatation
  • Biliary ductal dilatation (differential)
  • Dilatation of the bile ducts
  • Enlargement of the bile ducts

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