Common Bile Duct (CBD) Pathology

SONOACADEMY - ABDOMINAL ULTRASOUND

CBD

Common Bile Duct
Pathology

Sonographic Findings

A structured sonographic pathology index for the common bile duct, biliary obstruction, ductal dilatation, stones, inflammation, strictures and related conditions.

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CONTENTS COMMON BILE DUCT PATHOLOGY

01

NORMAL & ANATOMICAL VARIANTS

Normal duct anatomy, caliber and common anatomical variations

01

CBD (Common Bile Duct) Normal Extrahepatic Bile Duct Normal CBD Caliber Variation Post-Cholecystectomy CBD Dilatation Age-Related CBD Caliber Variation Distal CBD Visualization Limitation

02

CBD DILATATION & OBSTRUCTION

Sonographic patterns of ductal enlargement and biliary obstruction

02

Dilated Common Bile Duct Proximal CBD Dilatation Distal CBD Dilatation Diffuse Extrahepatic Biliary Dilatation Intrahepatic and Extrahepatic Biliary Dilatation Obstructive Biliary Dilatation Non-Obstructive CBD Dilatation Abrupt Distal CBD Cut-Off

03

CHOLEDOCHOLITHIASIS

Common bile duct stones, sludge and intraductal echogenic material

03

Choledocholithiasis Distal CBD Stone Proximal CBD Stone Multiple CBD Stones Impacted CBD Stone CBD Sludge Biliary Microlithiasis Intraluminal Biliary Debris Stone with Upstream Biliary Dilatation

04

CBD STRICTURES

Benign, inflammatory, postoperative and malignant ductal narrowing

04

Benign CBD Stricture Postoperative CBD Stricture Post-ERCP CBD Stricture Post-Inflammatory CBD Stricture Ischemic Bile Duct Stricture Malignant CBD Stricture Multifocal Biliary Strictures

05

CHOLANGITIS & INFLAMMATORY DISEASE

Inflammatory and infective processes involving the extrahepatic bile duct

05

Acute Cholangitis Recurrent Pyogenic Cholangitis Chronic Cholangitis Sclerosing Cholangitis Primary Sclerosing Cholangitis IgG4-Related Cholangitis Infective Biliary Inflammation

06

CHOLEDOCHAL CYSTS & CYSTIC DILATATION

Cystic and fusiform dilatation involving the extrahepatic biliary tree

06

Choledochal Cyst Type I Choledochal Cyst Type II Choledochal Cyst Type III Choledochal Cyst Type IV Choledochal Cyst Type V Fusiform CBD Dilatation Cystic Duct / Choledochal Cyst Relationship

07

BENIGN CBD LESIONS

Benign intraductal and duct-wall abnormalities

07

Benign Biliary Polypoid Lesion Inflammatory Biliary Lesion Biliary Wall Thickening Intraductal Biliary Debris Biliary Cast

08

MALIGNANT BILIARY DISEASE

Malignant obstruction and extrahepatic bile duct neoplasia

08

Extrahepatic Cholangiocarcinoma Distal Cholangiocarcinoma Perihilar Cholangiocarcinoma Malignant CBD Obstruction Bile Duct Wall Infiltration Metastatic Biliary Involvement

09

EXTRINSIC COMPRESSION

External processes producing common bile duct narrowing or obstruction

09

Pancreatic Head Mass Compressing CBD Periampullary Mass Enlarged Peripancreatic Lymph Nodes Porta Hepatis Lymphadenopathy Mirizzi Syndrome

10

POST-SURGICAL & IATROGENIC

Biliary abnormalities following surgery, intervention and instrumentation

10

Post-Cholecystectomy CBD Dilatation Biliary Stent in CBD Biliary Stent Occlusion Biliary Stent Migration Post-ERCP Biliary Changes Bile Duct Injury Postoperative Bile Leak Anastomotic Biliary Stricture

11

RELATED BILIARY OBSTRUCTIVE CONDITIONS

Important syndromes and combined biliary obstruction patterns

11

Mirizzi Syndrome with CBD Compression Gallstone-Related CBD Obstruction Biliary Sludge Obstruction Impacted Distal CBD Calculus Obstructive Jaundice Pattern

12

RARE & MISCELLANEOUS CBD FINDINGS

Unusual ductal appearances and miscellaneous sonographic findings

12

Biliary Cast Syndrome Pneumobilia Biliary Air-Liquid Level Hemobilia Bile Duct Blood Clot Parasitic Biliary Involvement Biliary Fungal Debris

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Common Bile Duct Pathology - Abdominal Ultrasound Education