Radiologic evaluation of obstructive jaundice using ultrasonography, computerized tomography and percutaneous transhepatic cholangiography

ABSTRACT

Ultrasound [US] and percutaneous transhepatic cholangiography [PTC] were performed in 21 patients while computerized tomography [CT] in 8 patients. We found US and CT comparably accurate in differentiating obstructive from non obstructive jaundice. The precise level of obstruction was identified by US in 95%, by CT in 88% and by PTC in 100%, while the cause of obstruction was accurately predicted by US in 52%, by CT in 88% and by PTC in 86% of cases. Associated abnormalities were perfectly described by CT in 100% and only in 55% of patients with US. The author believes that US is suitable to screen for biliary dilatation and to determine the level of obstruction while CT helps to verify the cause of obstruction and associated findings. PTC which is an invasive procedure should be reserved to cases with high obstruction, when US and CT are equivocal and if the surgeon is considering biliary drainage or bypass surgery