Title: Incidence of Periampullary Carcinoma as the Commonest Cause of Terminal CBD Obstruction – A Study Based on Computed Tomography Findings
Authors: Husna PC, Shameem Ahammed, Brahmadathan MN
DOI: https://dx.doi.org/10.18535/jmscr/v11i2.17
Abstract
Introduction: Biliary obstruction can occur anywhere in the tract carrying bile from liver to gall bladder and duodenum. Terminal CBD is the distal most part which is a common site for biliary obstruction. This study aims at finding various causes of terminal CBD obstruction and its characteristics using computed tomography imaging
Materials And Methods: Cross sectional study done at department of radiodiagnosis for a period of 2 years among 25 patients with clinically suspected obstructive jaundice and underwent contrast enhanced CT, diagnosed to have obstruction at terminal CBD level. CT diagnosis was correlated with ERCP or histopathology as applicable.
Results: Most common cause for terminal CBD obstruction was found to be periampullary malignancy (60%). Among them majority of cases were adenocarcinoma duodenum (53%). CT was (87%) accurate in detecting adenocarcinoma duodenum as the major cause of periampullary mass lesion.
Conclusion: Periampullary carcinoma is the common cause for terminal CBD obstruction
Keywords: periampullary mass lesion, adenocarcinoma duodenum, computed tomography.
References
- Khara HS, Kothari TH, Johal AS, Kothari ST, Ahuja N, Bhanushali A, Kotru A, Berger A, Kaul V, Gross SA, DiMaio CJ. Heads or tails: confusion about “proximal” and “distal” terminology for pancreaticobiliary anatomy. Endoscopy International Open. 2018 Jul;6(07):E801-5.
- She YM, Ge N. The value of endoscopic ultrasonography for differential diagnosis in obstructive jaundice of the distal common bile duct. Expert Review of Gastroenterology & Hepatology. 2022 Jul 3;16(7):653-64
- Joshi A, Rajpal K, Kakadiya K, Bansal A. Role of CT and MRCP in evaluation of biliary tract obstruction. Current Radiolog3y Reports. 2014 Nov;2(11):1-3.
- Choi SH, Han JK, Lee JM, Lee KH, Kim SH, Lee JY, Choi BI. Differentiating malignant from benign common bile duct stricture with multiphasic helical CT. Radiology. 2005 Jul;236(1):178-83.
- Zhao DZ, Guo Y, Sun YP, Liu HM, Zhang Z, Ma QL, Wang YS, Chen CL. Multi-detector spiral CT diagnosis of common bile duct ampullary carcinoma. Eur. Rev. Med. Pharmacol. Sci. 2017 Aug 1;21(16):3549-53.
- Suthar M, Purohit S, Bhargav V, Goyal P. Role of MRCP in differentiation of benign and malignant causes of biliary obstruction. Journal of clinical and diagnostic research: JCDR. 2015
- Nikolaidis P, Hammond NA, Day K, Yaghmai V, Wood III CG, Mosbach DS, Harmath CB, Taffel MT, Horowitz JM, Berggruen SM, Miller FH. Imaging features of benign and malignant ampullary and periampullary lesions. Radiographics. 2014 May;34(3):624-41.Nov;9(11):TC08.
- Mathew RP, Moorkath A, Basti RS, Suresh HB. Value and accuracy of multidetector computed tomography in obstructive jaundice. Polish journal of radiology. 2016;81:30.