Diagnostic Ultrasound - Abdomen and Pelvis

Approach to Biliary Sonography
(Left) Transverse oblique color
Doppler ultrasound of the
porta hepatis shows a dilated
common hepatic duct st,
differentiated from portal vein
ſt and left hepatic artery .
(Right) Transverse oblique
ultrasound of the common
hepatic duct post ERCP shows
ductal dilatation with
pneumobilia ſt and debris st.
Pneumobilia may obscure
stones.
Diagnoses: Biliary System
(Left) Longitudinal oblique
ultrasound of the porta
hepatis in a patient with
jaundice shows a dilated
common hepatic duct st with
two echogenic nonshadowing
stones ſt. The portal vein
and proper hepatic artery
are shown. (Right)
Longitudinal oblique color
Doppler ultrasound of the
same patient shows no color
flow in the bile duct stones ſt.
Presence of flow in a bile duct
lesion suggests mass.
(Left) Longitudinal oblique
ultrasound of the porta
hepatis in a patient with
jaundice after
cholecystectomy shows a
dilated common hepatic duct
st measuring 16 mm. The
distal bile duct was obscured
by gas . CT showed a
pancreatic head carcinoma.
Artifact from cholecystectomy
clips was present ſt. (Right)
Transverse ultrasound of the
left lobe of the liver in the
same patient shows diffuse st
intrahepatic biliary dilatation.
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