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Dr Uzair
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what is mild increase in dilation of the bile and pancreatic

Resolved Question:

what is mild increase in dilation of the bile and pancreatic ducts mean?
Submitted: 4 years ago.
Category: Medical
Expert:  Dr Uzair replied 4 years ago.

Hi.
Welcome to JustAnswer. I shall try my best to assist you while you are corresponding with me.

 

It specifies that the duct carrying bile from the gall bladder and pancreatic juice from the pancreas are mildly dilated. Such happens when there is some form of obstruction in their lumens. This obstruction can be caused by stones (small ones) passing in through the duct of the gall bladder (cystic duct) in to the common bile duct (which is formed by joining of the gall bladder duct and the common heptic duct, coming from the liver). The stones as they pass through the bile duct dilate it and most of them pass through it like this due to back pressure form the bile, others can obstruct the lumen and cause severe pain and jaundice. These stones can lodge near the ampulla of vater (the opening of the bile duct and pancreatic duct in the small intestine) and cause dilatation of the bile duct as well as the pancreatic duct due to stasis of bile and pancreatic fluid in them.

To understand this you will need to see this picture:

graphicgraphic

 

Both these pictures will help you understand the anatomy of the hepatobiliary system and you can imagine, any obstruction to the flow of bile near the ampulla of vater or sphincter of oddi will result in dilation of the proximal bile ducts.

However, mild bile duct dilation is of little significance and does not cause serious issues. But the gall bladder should be examined via an ultrasound to determine any stones in it and the Common bile duct should also be seen in this ultrasound to visualize any debris or stones obstructing its lumen.

 

--Best wishes--

Customer: replied 4 years ago.
I had my gall bladder removed last summer,my Dr said I have a chance of narrowing in the distal most part of the ducts called a stricture or stinosis. He recommends an endoscopic ultrasound. Thats not the same as an ercp is it?
Expert:  Dr Uzair replied 4 years ago.

Thanks for the input.

 

No, it is not, the principal is the same in that a (ultrasound) probe especially designed for this purpose, will be passed down your oesophagus and ultrasound will be done by it.

ERCP is a different modality of diagnostic as well as therapeutic value.

 

A stricture in the distal bile duct can also act as to dilate the proximal part by causing stasis of bile and obstruction to its flow. This backlog of bile increases the pressure in the bile ducts and dilates them. Same as the stones would do.

 

--Best--



Edited by Dr Uzair on 7/17/2010 at 10:20 PM EST
Customer: replied 4 years ago.
Sorry one more question. I had an ercp last year and I got really sick from it. I could barely swallow for two weeks and I had to return to the hospital the day of the ercp with horrific pain .( possile pancreatis) can this happen with this test?
Expert:  Dr Uzair replied 4 years ago.

You can ask me as many questions as you want :)

Yes, the two most common complications of this procedure are:

1) Acute pancreatitis

2) Ascending cholangitis

 

That is why this procedure is being largely abandoned as a diagnostic modality and MRCP is being used which is better than ERCP as a diagnostic tool and not invasive but ERCP still holds it's grounds as being a better therapeutic modality, for taking biopsies and to perform sphincterotomy, to release the stones stuck in the Common Bile Duct.

 

--Hope this helps--

Customer: replied 4 years ago.
so maybe i wont get sick with the endoscopic ultrasound like i did with the ERCP
Expert:  Dr Uzair replied 4 years ago.
The sole reason that the ERCP causes acute pancreatitis or cholangitis is because of the dye and the infiltration of foreign bodies with in the bile ducts in order to visualize them as a part of the test. This is not done with the EUS (Endoscopic ultrasound). So, no, you will not get sick with the EUS, like you did with the ERCP.
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Category: Medical
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Experience: MBBS, FCPS (R) General Surgery. Years of experience in Emergency Medicine.
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Dr Uzair
Dr Uzair
FCPS (R) General Surgery
3518 Satisfied Customers
MBBS, FCPS (R) General Surgery. Years of experience in Emergency Medicine.