A CLINICAL INVESTIGATION ON 17 CASES OF IDIOPATHIC CHOLEDOCHUS DILATATION IN ADULT DIAGNOSED BY ERCP

WITH SPECIAL REFERENCE TO CHOLANGIOGRAM AND ANOMALOUS PANCREATICO-BILIARY DUCTAL ANASTOMOSIS

Abstract

1) The incidence of clinical symptoms were as follows : abdominal pain 82%, fever or nausea 35%, jaundice 24% and abdominal mass 12%. The incidence of fever was higher than that of jaundice or abdominal mass. Laboratory studies of blood were normal in one-half of the cases. 2) They were divided into two types, cystic dilatation type in 6 cases and cylindrical dila-tation type in 7 cases following ERCP. Extrahepatic type in 7 cases having no intrahe paticductal dilatation and intra-and extrahepatic type in 6 cases having both intra and extra he paticductal dilatation were recognized. 3) The mode of pancreatico-biliary anastomosis were classified into two types, one is pancreatic duct flowing into common bile duct in 3 cases and the other was common bile duct flowing into pancreatic duct in 13 cases. Anomalous pancreatico-biliary tract anastomosis were recognized in all 16 cases. 4) The maximum diameter of the extrahepatic bile duct co-related to the degree of the terminal choledochal stenosis. 5) A case of idiopathic choledochus dilatation associated with cancer of the liver and two cases accompanied by pancreatolithiasis were observed in the present series.