Pre-hospital detection of intrahepatic biliary duct dilatation: recognizing the abundance of vessels in the liver

Miravent, Sérgio; Lobo, Manuel; Almeida, Rui Pedro de

http://hdl.handle.net/10400.11/10037

Use this identifier to reference this record.

Name:	Description:	Size:	Format:
1-s2.0-S2405469024000839-main.pdf		314.66 KB	Adobe PDF	Download

Send Feedback

Authors

Miravent, Sérgio

Lobo, Manuel

Almeida, Rui Pedro de

Abstract(s)

Diagnosing and confirming intrahepatic biliary duct dilation (IHBDD) involves a coordinated effort across multiple medical specialties, often relying on comprehensive blood analysis. However, the utility of screening ultrasound in detecting intrahepatic biliary dilation becomes particularly valuable in pre-hospital settings like our Basic Emergency Service, especially when access to alternative imaging techniques or detailed blood analyses are unavailable. Detecting the intrahepatic biliary dilation pattern through ultrasound is notably straightforward for a skilled sonographer. The presence of IHBDD can be efficiently identified during a screening ultrasound, allowing identification of imaging findings that help differentiate simple biliary colic from clinical cases that should be prompt referral to the reference hospital and without unnecessary delays or resource expenditure. The etiology of IHBDD is multifactorial1, and while its presentations may vary, the characteristic ultrasound pattern often involves the visualization of “extra vessels within the liver,” related to the distinctive “shotgun” sign2. This sign translates into the observation of dilated bile ducts exhibiting no flow on Doppler imaging3. In cases of extrahepatic obstruction, dilation of the common bile duct (CBD) may be evident. However, with intrahepatic obstruction, a normal CBD caliber can occur. Thus, the sonographer needs to diligently observe the signs outlined and typical sonographic landmarks to identify early indications of bile duct dilation within the innermost or regions of the liver.

Keywords

Biliary Intrahepatic Screening Ultrasonography

URI

http://hdl.handle.net/10400.11/10037

Citation

MIRAVENT, Sérgio ; LOBO, Manuel ; ALMEIDA, Rui (2024) - Pre-hospital detection of intrahepatic biliary duct dilatation: recognizing the abundance of vessels in the liver. Visual Journal of Emergency Medicine. DOI: 10.1016/j.visj.2024.101992