Abdominal Ultrasound—Liver, Spleen and Biliary Tree

2022 ◽  
pp. 159-207
Author(s):  
James M. Pilcher ◽  
Pawan Patel
Keyword(s):  
Biliary Tree ◽  
Abdominal Ultrasound

scholarly journals Utilizing of MRCP/MRI in differentiation between benign and malignant biliary obstruction

2018 ◽  
Vol 9 (1) ◽  
pp. 51
Author(s):  
Amjaad Majeed Hameed
Keyword(s):  
Magnetic Resonance ◽  
Strong Correlation ◽  
Biliary Obstruction ◽  
Correct Diagnosis ◽  
Magnetic Resonance Cholangiopancreatography ◽  
Biliary Tree ◽  
Abdominal Ultrasound ◽  
Final Diagnosis ◽  
Pancreatic Ducts ◽  
Biliary Dilatation

Obstruction is one of the most common problems in biliary tree pathology, combined magnetic resonance imaging (MRI) and Magnetic Resonance Cholangiopancreatography (MRCP) regarded as accurate imaging modalities in diagnosis the cause of obstruction and treatment planning due to information obtain from MRCP about biliary and pancreatic ducts, information obtains from MRI cross sections about surrounding parenchyma. This study was aimed to investigate the efficacy of combined MRCP and MRI in differentiation between benign and malignant causes of biliary dilatation and their sensitivity in detection specific cause of biliary dilatation. This study involved 72 patients and conducted in Al-Diwaniyah Teaching Hospital, Iraq during a period from February 2013 to June 2017, the diagnosis of biliary dilatation was done by abdominal ultrasound to all patients followed by MRCP/MRI, the results of MRCP/MRI was compared with final diagnoses done by endoscopic retrograde cholangiopancreatography (ERCP), surgical, histopathological and laboratory results. The results revealed that a strong correlation between MRCP/MRI and other gold standard tools in differentiation between benign and malignant causes of obstruction. Sensitivity, specificity, and accuracy of MRCP in differentiation between malignant and benign causes of biliary dilatation were 98.4%, 100% & 99.7% respectively. There was a strong correlation (0.990) between MRCP/MRI & final diagnosis to determine the specific cause of obstruction, correct diagnosis the cause of obstruction in 68 patients out of 72 with a sensitivity of 94%. This study concluded that combined MRCP/MRI plays an important role in differentiation benign & malignant causes of biliary obstruction and in differentiation the specific cause of obstruction. Keywords: MRI; MRCP; Biliary obstruction; ERCP

Feline abdominal ultrasonography: what’s normal? what’s abnormal? Hepatic vascular anomalies

2019 ◽  
Vol 21 (7) ◽  
pp. 645-654
Author(s):  
Sally Griffin
Keyword(s):  
Biliary Tree ◽  
Abdominal Ultrasound ◽  
Evidence Base ◽  
Vital Role ◽  
Vascular Anomalies ◽  
Abdominal Ultrasonography ◽  
Operator Experience ◽  
Ultrasound Technology ◽  
High Resolution Images ◽  
Diagnostic Work

Practical relevance: Abdominal ultrasound plays a vital role in the diagnostic work-up of many cats presenting to general and specialist practitioners. Although hepatic vascular anomalies are less common than disorders of the hepatic parenchyma and biliary tree, our understanding and recognition of these is gradually increasing with advancements in ultrasound technology and image quality. Clinical challenges: Despite ultrasonography being a commonly used modality, many practitioners are not comfortable performing an ultrasound examination or interpreting the resulting images. Even differentiating between normal variation and pathological changes can be challenging for all but the most experienced. In addition, some views may be obscured by overlying structures; for example, the termination of a shunt entering the left phrenic or azygous veins is often difficut to see due to the high probability of lung passing between the shunt and the transducer as the cat breathes. Equipment: Ultrasound facilities are readily available to most practitioners, although use of ultrasonography as a diagnostic tool is highly dependent on operator experience. Aim: This review, part of an occasional series on feline abdominal ultrasonography, discusses the appearance of various hepatic vascular anomalies. It is aimed at general practitioners who wish to improve their knowledge and confidence in feline abdominal ultrasound and is accompanied by high-resolution images. Ultrasound of the liver and biliary tree were discussed in articles published in January and May 2019, respectively. Evidence base: Information provided in this article is drawn from the published literature and the author’s own clinical experience.

scholarly journals Prevalence of pancreaticobiliary reflux in symptomatic cholelithiasis and its significance

2014 ◽  
Vol 9 (1) ◽  
pp. 1-6
Author(s):  
TP Bohara ◽  
A Parajuli ◽  
GR Bajracharya ◽  
MR Joshi
Keyword(s):  
Gall Bladder ◽  
Serum Amylase ◽  
Biliary Tree ◽  
Abdominal Ultrasound ◽  
Amylase Level ◽  
Bile Sample ◽  
Symptomatic Cholelithiasis ◽  
Study Materials ◽  
Calot’S Triangle ◽  
Functionally Impaired

Aims: Pancreaticobiliary reflux (PBR) is reflux of pancreatic enzymes into the biliary tree which occurs as a result of an anamoly of pancreaticobiliary junction (PBJ) or functionally impaired sphincter. PBR is associated with changes in biliary epithelium and is known to cause benign and malignant biliary pathology. Various authors have reported prevalence of PBR in patients with normal PBJ ranging from 20 % to 83.5 %. With aim to detect the prevalence of PBR in patients with symptomatic cholelithiasis in Nepalese population we conducted this study. Materials and methods: Thirty patients undergoing elective laparoscopic cholecystectomy (LC) for symptomatic cholelithiasis were included in the study. History, physical findings and relevant investigations including liver function test, serum amylase and abdominal ultrasound were recorded. Bile sample for amylase was taken from gall bladder during LC percuatneously before manipulation of calot’s triangle and common bile duct. Bile amylase level above serum amylase level was considered positive for PBR. Results: Mean age of the patient was 37.27 (± 14.41) years. Out of 30, 6 (20 %) patients were male and 24 (80 %) were female. Mean BMI was 21.58 (± 3.2). PBR reflux was present in 66.7 % of patients out of which 2 were male and 18 were female that was not statistically significant (p = 1.41) when compared with patients without PBR. Conclusion: PBR occurs in patient with cholelithiasis and has role in pathogenesis of gallstones disease and gall bladder carcinoma. Long term surveillance would be required to ascertain the significance of detection of PBR after LC. Journal of College of Medical Sciences-Nepal, 2013, Vol-9, No-1, 1-6 DOI: http://dx.doi.org/10.3126/jcmsn.v9i1.9666

scholarly journals Management of ampullary tumours in children: still a challenge

2017 ◽  
Vol 99 (5) ◽  
pp. e139-e141
Author(s):  
P Fernandez-Eire ◽  
JL Vazquez Castelo ◽  
M Herreros Villaraviz ◽  
B Fernandez Caamaño ◽  
J Gonzalez-Carreró ◽  
...  
Keyword(s):  
Magnetic Resonance Cholangiopancreatography ◽  
Biliary Tree ◽  
Abdominal Ultrasound ◽  
High Morbidity ◽  
Low Grade ◽  
Endoscopic Retrograde ◽  
Ampullary Adenoma ◽  
Villous Tumour ◽  
Pancreatic Duct Dilatation

This study describes the case of the youngest patient ever reported with ampullary adenoma. The incidence of ampullary adenomas in childhood is unknown. Endoscopic retrograde cholangiopancreatography (ERCP) and endoscopic ultrasound are used in adults to assess and treat these lesions, although there are no instruments designed specifically for use in young children. A six-year-old girl was admitted for abdominal pain, vomiting, pruritus and weight loss. Abdominal ultrasound showed biliary tree (8mm) and pancreatic duct dilatation (4mm). Magnetic resonance cholangiopancreatography and computed tomography confirmed these findings, and also showed displacement of the ampulla to the left upper quadrant. An upper endoscopy confirmed a large ampullary adenoma.A laparotomy was performed and a 5cm villous tumour arising from the ampulla was excised. The postoperative course was uneventful. The histology demonstrated adenoma of the ampulla (intestinal type) without low-grade dysplasia. all clinical and radiological parameters are normal at 20 months follow-up.We describe the case of the youngest patient ever reported with ampullary adenoma. Pancreaticoduodenectomy carries high morbidity and mortality rates, and therefore it should be avoided in absence of histologically proven malignancy. We believe that surgical ampullectomy is a safe and oncologically correct procedure until better endoscopic instruments for peadiatric use will be designed.

scholarly journals Conservative Treatment for Cystic Duct Stenosis in a Child

2013 ◽  
Vol 2013 ◽  
pp. 1-3
Author(s):  
Marco Gasparetto ◽  
Laura Giordano ◽  
Mara Cananzi ◽  
Valeria Beltrame ◽  
Gianni Bisogno ◽  
...  
Keyword(s):  
Abdominal Pain ◽  
Cystic Duct ◽  
Biliary Tree ◽  
Abdominal Ultrasound ◽  
Bile Duct Stenosis ◽  
Mr Cholangiography ◽  
One Year ◽  
Gallbladder Hydrops ◽  
Extrahepatic Biliary Tree ◽  
Duct Stenosis

Introduction. Few cases of common bile duct stenosis have been reported in the literature, and observations of strictures in the cystic duct are even more rare. Surgical cholecystectomy is the treatment needed in most cases of gallbladder hydrops. This paper describes the diagnosis and successful medical treatment of a rare pediatric case of cystic duct stenosis and gallbladder hydrops.Case Report. A formerly healthy one-year-old girl was admitted with colicky abdominal pain. Blood tests were normal, except for an increase in transaminases. Abdominal ultrasound excluded intestinal intussusception and identified a distended gallbladder with biliary sludge. MR cholangiography revealed a dilated gallbladder containing bile sediment and no detectable cystic duct, while the rest of the intra- and extrahepatic biliary tree and hepatic parenchyma were normal. This evidence was consistent with gallbladder hydrops associated with cystic duct stenosis. The baby was treated with i.v. hydration, corticosteroids, antibiotics, and ursodeoxycholic acid. Her general condition rapidly improved, with no further episodes of abdominal pain and normalization of liver enzymes. This allowed to avoid cholecystectomy, and the child is well 1.5 years after diagnosis.Conclusions. Although cholecystectomy is usually necessary in case of gallbladder hydrops, our experience suggests that surgical procedures can be avoided when the distension is caused by a cystic duct stenosis.

scholarly journals Feline abdominal ultrasonography: what’s normal? what’s abnormal? The liver

2018 ◽  
Vol 21 (1) ◽  
pp. 12-24 ◽  
Author(s):  
Sally Griffin
Keyword(s):  
Ultrasound Examination ◽  
Biliary Tree ◽  
Abdominal Ultrasound ◽  
Liver Parenchyma ◽  
Evidence Base ◽  
Vital Role ◽  
Abdominal Ultrasonography ◽  
Operator Experience ◽  
Hepatic Neoplasia ◽  
Diagnostic Work

Practical relevance: Abdominal ultrasound plays a vital role in the diagnostic work-up of many cats presenting to general and specialist practitioners. Ultrasound examination of the liver can be key in the diagnosis of diseases such as hepatic lipidosis and hepatic neoplasia. Clinical challenges: Despite ultrasonography being a commonly used modality, many practitioners are not comfortable performing an ultrasound examination or interpreting the resulting images. Even differentiating between normal variation and pathological changes can be challenging for all but the most experienced. When assessing the liver via ultrasound, a diffuse alteration in liver echogenicity may be difficult to detect unless the change is marked and, although comparisons can be made with the spleen and kidneys, this relies on these organs being normal. Equipment: Ultrasound facilities are readily available to most practitioners, although use of ultrasonography as a diagnostic tool is highly dependent on operator experience. Aim: This review, the first in an occasional series on feline abdominal ultrasonography, discusses ultrasonographic examination of the normal and diseased liver, with focus on the liver parenchyma. It is aimed at general practitioners who wish to improve their knowledge of and confidence in feline abdominal ultrasound and is accompanied by high-resolution images. Ultrasound-guided sampling of the liver is also covered. Future articles will discuss the biliary tree and hepatic vascular anomalies. Evidence base: Information provided in this article is drawn from the published literature and the author’s own clinical experience.

Feline abdominal ultrasonography: what’s normal? what’s abnormal? The biliary tree

2019 ◽  
Vol 21 (5) ◽  
pp. 429-441 ◽  
Author(s):  
Sally Griffin
Keyword(s):  
Gall Bladder ◽  
Bile Ducts ◽  
Ultrasound Examination ◽  
Biliary Tree ◽  
Abdominal Ultrasound ◽  
Liver Parenchyma ◽  
Evidence Base ◽  
Vital Role ◽  
Abdominal Ultrasonography ◽  
Operator Experience

Practical relevance: Abdominal ultrasound plays a vital role in the diagnostic work-up of many cats presenting to general and specialist practitioners. The biliary tree encompasses the liver, gall bladder and bile ducts, although only diseases affecting the latter two are discussed here. Diseases of the bile ducts and gall bladder are more common than those of the liver parenchyma and ultrasound plays an important role in their diagnosis. Clinical challenges: Despite ultrasonography being a commonly used modality, many practitioners are not comfortable performing an ultrasound examination or interpreting the resulting images. Even differentiating between normal variation and pathological changes can be challenging for all but the most experienced. In addition, a lack of pathological change does not necessarily rule out disease; for example, absence of gall bladder and/or extrahepatic biliary distension is not sufficient to exclude the possibility of biliary obstruction, and in many cases of cholangitis the liver and biliary tree are unremarkable on ultrasound examination. Equipment: Ultrasound facilities are readily available to most practitioners, although use of ultrasonography as a diagnostic tool is highly dependent on operator experience. Aim: This review, part of an occasional series on feline abdominal ultrasonography, discusses the appearance of the normal and diseased biliary system. It is aimed at general practitioners who wish to improve their knowledge and confidence in feline abdominal ultrasound and is accompanied by high-resolution images. Percutaneous ultrasound-guided cholecystocentesis is also covered. Ultrasound examination of the liver was discussed in an article published in January 2019 and an upcoming article will cover hepatic vascular anomalies. Evidence base: Information provided in this article is drawn from the published literature and the author’s own clinical experience.

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