Ultrasound in choledocholithiasis.

Twenty-five patients of obstructive jaundice due to choledocholithiasis, were prospectively evaluated by ultrasonography and cholangiography. Ultrasound could demonstrate choledocholithiasis in 10 patients (40%). Choledocholithiasis in non-dilated ducts could be demonstrated only in one patient. All cases were diagnosed by cholangiography. Ultrasound, though an accepted modality of choice for diagnosing cholelithiasis, has a limited role in the diagnosis of choledocholithiasis. Ultrasonography (USG) is the screening modality of choice to distinguish obstructive from non-obstructive jaundice. It is highly accurate in the diagnosis of cholelithiasis but its role in detection of choledocholithiasis is less clear. Choledocholithiasis complicates 10% of all cases of cholecystitis and occurs in 2-4% of postcholecystectomy patients. The present study deals with the diagnostic value of USG in cases of choledocholithiasis subjected to USG prior to cholangiography and surgery.

Ultrasound in obstructive jaundice.

One hundred and twenty-five consecutive patients with obstructive jaundice were prospectively studied by ultrasonography to determine the level and cause of obstruction. These were diagnosed precisely in 80 (72%) and 52 patients (41.6%) respectively. The results were compared with cholangiography. The final diagnosis was established at surgery (97 cases) and fine needle aspiration cytology (28 cases). While US is an excellent screening modality in distinguishing obstructive and non-obstructive jaundice, cholangiography is still the gold standard for determining the precise anatomic level and cause of obstruction.