Computed tomography in obstructive jaundice. Part II: The cause of obstruction.

Abstract

The value of computed tomography (CT) in determining the cause of obstructive jaundice in 67 proved cases is described. The presence of stones, the level of obstruction, the relative size of the ringlike structures produced by the dilated bile duct, and the shape of the distal visualized ring have proved to be the most important variables. The retrospective analysis determined the correct cause in 94% of the cases. CT fulfills all goals considered important in obstructive jaundice and eliminates the need for invasive procedures in many cases.

Intravenous cholangiography in the CT era

“…US revealed obstruction in 87% of these patients, although it demonstrated the cause of obstruction less frequently. Similar findings for the accuracy of CT and US have appeared in other recent reports [9][10][11][12]. In our series, CT was utilized in only 3 patients with surgically proven common duct stones.…”

“…The utility of US and CT in the diagnosis of surgical cholestasis is well-documented [6][7][8][9][10][11]. Baron et al demonstrated the value of US and CT in the diagnosis of biliary obstruction [6].…”

The role of ERCP in choledocholithiasis

“…Reported CT sensitivity for CBDS ranges from 25-90% [55,[60][61][62]. PTC is accurate in detecting CBDS when the bile duct is opacified.…”

An Experience in Management of Surgical Obstructive Jaundice

“…The sensitivity and predictive value of computed tomography in diagnosis of obstruction is comparable to that of usa and in addition it is more likely to yield clues regarding the level or the nature of the obstruction [13,14].…”