Choledocholithiasis: Common Cause of Extrahepatic Biliary Obstructive Jaundice and Diagnostic Efficiency of Ultrasonography (original) (raw)

Background: Noninvasive methods that have been used for diagnosis of bile duct stones include ultrasonography, computed tomography and magnetic resonance cholangiopancreatography without use of contrast media. Ultrasonography is the popular, safe, cost effective and effective initial modality for the investigation of obstructive jaundice. Objectives: To identify the magnitude of calculus disease as the cause of extra hepatic biliary obstructive jaundice and role of ultrasonography in the diagnosis. Methodology: One year (Aug 2005-July 2006) case records of obstructive jaundice attended in Bir Hospital for ERCP were analyzed. Those all cases were evaluated by ultrasonography prior to admission in the hospital. Among them, the record of those cases carrying or suspected choledochocholithiasis was identified and their USG findings correlated with the ERCP results. Results: Among the 73 case records enrolled in study, 20 cases were diagnosed choledocholithiasis, and suspected same in other 4 with other differential diagnosis. ERCP diagnosis was similar in 20 cases, among other four cases with differential diagnosis, two were found to be stone in distal CBD and there was periampulary mass in one. Another one case was negative for calculus disease but it was diagnosed juxta papillary diverticulum, otherwise the ERCP was reported no obstructing lesion. This result shows USG diagnosis was correct in 83.33%, supportive in two and different in remaining two cases in comparison to ERCP. Choledocholithiasis was more common in female(N=15, 75.0%) than the male (N=4, 25.0%). Conclusion: Our result indicate that the majority of cases of choledocholithiasis can be diagnosed with ultrasonography.