Document Detail

Duodenal EUS to identify thickening of the extrahepatic biliary tree wall in primary sclerosing cholangitis.
MedLine Citation:
PMID:  16500387     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: Diagnosing primary sclerosing cholangitis (PSC) is problematic and requires meeting a burden of proof through clinical, biochemical, radiologic, and histological features. Endoscopic ultrasound yields detailed images of the extrahepatic biliary tree, but its value in contributing to the diagnosis of this condition is unknown. OBJECTIVES: To determine the potential for transduodenal EUS to detect common bile duct wall thickening in PSC. DESIGN: A prospective, controlled study with retrospective, blinded data analysis. SETTING: Single tertiary referral center for inflammatory bowel disease and EUS. PATIENTS: Four groups of patients were assessed with radial endosonography: PSC (n = 9); inflammatory bowel disease (IBD) with abnormal liver blood tests (n = 21); choledocholithiasis (n = 15); and normal controls (n = 50). Measurements were made of the common bile duct diameter and wall thickness. INTERVENTIONS: Transduodenal radial EUS of the biliary tree. MAIN OUTCOME MEASUREMENTS: Common bile duct diameter and wall thickness. RESULTS: The mean diameter (SD) of the common bile duct for the PSC, IBD, choledocholithiasis, and normal control groups measured 8.9 mm (2.8), 5.4 mm (1.7), 7.2 mm (2.2), and 5.0 mm (1.9), respectively (PSC and choledocholithiasis groups compared to the IBD group, P < .05 for a single test of hypothesis, but correction for the multiple testing of data removed this significance; normal control group P < .005). Mean ductal wall thickness (SD) was 2.5 mm (0.8) for the PSC group, 0.7 mm (0.4) for the IBD group, 0.8 mm (0.4) for the choledocholithiasis group, and 0.8 mm (0.4) for the normal control group, respectively (PSC group compared to the other 3 groups, P < .005). LIMITATIONS: Assessment of intrahepatic PSC is problematic. CONCLUSION: Thickening (>1.5 mm) of the common bile duct wall is seen in patients with PSC but not in those with apparently uncomplicated IBD or choledocholithiasis. The results of this study suggest that standard endosonography contributes to the imaging and potentially to the diagnosis of PSC.
Steven Mesenas; Charles Vu; Laura Doig; John Meenan
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Publication Detail:
Type:  Comparative Study; Controlled Clinical Trial; Journal Article    
Journal Detail:
Title:  Gastrointestinal endoscopy     Volume:  63     ISSN:  0016-5107     ISO Abbreviation:  Gastrointest. Endosc.     Publication Date:  2006 Mar 
Date Detail:
Created Date:  2006-02-27     Completed Date:  2006-08-01     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  0010505     Medline TA:  Gastrointest Endosc     Country:  United States    
Other Details:
Languages:  eng     Pagination:  403-8     Citation Subset:  IM    
Department of Gastroenterology, Guy's and St. Thomas' Hospital, London, England.
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MeSH Terms
Bile Ducts, Extrahepatic / pathology*,  ultrasonography*
Cholangitis, Sclerosing / pathology*,  ultrasonography*
Choledocholithiasis / pathology,  ultrasonography
Inflammatory Bowel Diseases / pathology,  ultrasonography
Liver Function Tests
Middle Aged
Prospective Studies
Retrospective Studies

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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