September 2009

Abnormal bile ducts

Bookmark

Clinical information

Raised bilirubin levels

Ultrasound Images & Clips

85 year old female, Raised bilirubin levels

The common hepatic duct is filled with echogenic structures without acoustic shadowing

The same structures are seen in the distal common bile duct

Detail of the structures in the common bile duct

Transverse image of the distal common bile duct at the level of the pancreatic head with an intraluminal structure.

Longitudinal image of the gallbladder. The same structures are seen in the gallbladder The structures do not cause acoustic shadowing and represent inspisated bile or sludge. The sludge can clump together and form sludge balls. It can be difficult to dif

The next case is a 55 year old female patient with jaundice. In this case the bile ducts are completely filled with echogenic material again without acoustic shadowing. In this case the bile ducts are completely filled with sludge and stones.

Only on the detail image it is clear that it is not one tumor but multiple structures clumped together

Detail of the bile duct with sludge and stones

An ERCP and papillotomy confirmed the diagnosis in this case

This longitudinal image of a choangiocarcinoma with a soft tissue mass in the common bile duct illustrates the resemblance with a sludge filled bile duct.

Details

Sex: Female
Age: 85

Created with

Fujifilm Ultrasound System

Browse through our ultrasound product portfolio

Looking for MSK Ultrasound Education? Visit Sonoskills.com

Author

Dr. Taco Geertsma

Retired Radiologist, Gelderse Vallei Hospital

Dr. Taco Geertsma is the founder of UltrasoundCases.info and a retired radiologist and has worked in the Gelderse Vallei hospital from January 1, 1983. till July 1, 2014. He was the head of the ultrasound department for many years.

More Cases from Taco Geertsma

[{"listLocation":"abdomen-and-retroperitoneum","icon":"001-abdomen-white.svg","header":"Abdomen and retroperitoneum","id":63},{"listLocation":"urinary-tract-and-male-reproductive-system","icon":"002-urinary-tract-white.svg","header":"Urinary Tract and male reproductive system","id":64},{"listLocation":"gynaecology","icon":"003-gynaecology-white.svg","header":"Gynaecology","id":65},{"listLocation":"head-and-neck","icon":"004-head-neck-white.svg","header":"Head and Neck","id":66},{"listLocation":"breast-and-axilla","icon":"005-breast-white.svg","header":"Breast and Axilla","id":67},{"listLocation":"musculo-skeletal-joints-and-tendons","icon":"006-msk-joints-white.svg","header":"Musculoskeletal Joints and Tendons","id":68},{"listLocation":"musculo-skeletal-bone-muscle-nerves-and-other-soft-tissues","icon":"007-msk-bones-white.svg","header":"Musculoskeletal, bone, muscle, nerves and other soft tissues","id":69},{"listLocation":"thorax","icon":"008-thorax-white.svg","header":"Thorax","id":70},{"listLocation":"pediatrics","icon":"009-pediatrics-white.svg","header":"Pediatrics","id":71},{"listLocation":"peripheral-vessels","icon":"010-peripheral-vessels-white.svg","header":"Peripheral vessels","id":72}]