Document Detail

Biliary varices on endoscopic ultrasonography: clinical presentation and outcome.
MedLine Citation:
PMID:  10917183     Owner:  NLM     Status:  MEDLINE    
BACKGROUND AND STUDY AIMS: Bile duct varices are not a well-recognized feature of portal venous obstruction. The aim of the present study was to describe the clinical and endosonographic features of biliary involvement in patients with extrahepatic portal venous obstruction (EPVO). PATIENTS AND METHODS: A retrospective study was conducted of the clinical features, outcome, and endosonographic findings (using Olympus EUM-3 or EUM-20 probes) in 21 patients with EPVO and endosonographic features of biliary varices. Biliary varices were defined as multiple, large, serpiginous, anechoic vascular channels in and/or surrounding the extrahepatic biliary tracts. RESULTS: Biliary varices have not previously been visible using conventional imaging methods (computed tomography and ultrasonography). They were identified using EUS in the wall of the common bile duct in 16 patients (76%), surrounding the common bile duct (CBD) in 11 patients (52%), and in the gallbladder in nine (43%). The varices were the cause of obstructive jaundice in three of the 21 patients (14%), but only when they were in the wall of the CBD. Two of these patients were treated using portosystemic shunting, and the other received a biliary endoprosthesis. The EUS examination also provided evidence of unrecognized pancreatic or biliary tumors in three other patients with EPVO of undetermined origin. CONCLUSIONS: EUS can serve to diagnose biliary varices in patients with EPVO and jaundice. Although biliary varices are mainly asymptomatic, they may cause obstructive jaundice when they are located in the wall of the CBD. EUS can also detect unrecognized malignant tumors in patients with EPVO of undetermined origin.
L Palazzo; P Hochain; C Helmer; E Cuillerier; B Landi; G Roseau; P H Cugnenc; J P Barbier; C Cellier
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Endoscopy     Volume:  32     ISSN:  0013-726X     ISO Abbreviation:  Endoscopy     Publication Date:  2000 Jul 
Date Detail:
Created Date:  2000-12-11     Completed Date:  2000-12-11     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  0215166     Medline TA:  Endoscopy     Country:  GERMANY    
Other Details:
Languages:  eng     Pagination:  520-4     Citation Subset:  IM    
Dept. of Gastroenterology, Georges Pompidou European Hospital, University of Paris V, France.
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MeSH Terms
Cholestasis, Extrahepatic / etiology,  therapy,  ultrasonography*
Common Bile Duct / blood supply*,  ultrasonography
Constriction, Pathologic / complications,  ultrasonography
Gallbladder / blood supply*,  ultrasonography
Middle Aged
Portal Vein / ultrasonography
Portasystemic Shunt, Surgical
Varicose Veins / complications,  therapy,  ultrasonography*

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