Choledocholithiasis - biliary stone in the common bile duct - MRI - by RadiologieTV скачать в хорошем качестве

Choledocholithiasis - biliary stone in the common bile duct - MRI - by RadiologieTV

This video is about Choledocholithiasis which is the medical term for a biliary stone in the common bile duct. The stone might either have formed within the duct and is considered a primary duct stones or a gallstone has passed into the common bile duct which is then considered a secondary duct stone. The causes of gallstone or duct stone formation are hyperalimentation with obesity, hemolytic anemias, congenital anomalies of the bile duct or recurrent cholangitis just to name a few. Females are affected more common than males and the typical age group is around the 4th decade although it can be seen in all age groups. The Symptoms are about the same as with symptomatic stones in the gall bladder namely right upper quadrant pain, pruritus and jaundice due to cholestasis. If the stone is situated at the lower end in the common bile duct it might also obstruct the pancreatic duct with which it has a common junction into duodenum and thus leading to pancreatitis. The gold standart for detecting stones in the common biile duct is the ERCP which stands for endoscopic retrograde cholangiopancreaticography where stones are seen as radiolucent filling defects. Another method that manages without X-rays and contrast media is the MRCP which stands for magnetic resonance cholangiopancreaticography. The MRCP uses either a so called RARE or HASTE techniques which both have a strong T2 character. With this method you can see a low signal filling defect within the very bright signal of the bile. With MRI you have the advantage of being able to evaluate the periductual tissues and organs as well and thus ruling out an extrinsing obstruction of the bile duct which can lead to the same symptoms. While small stones up to 3mm usually pass spontaneously lager stones might require endoscopic sphincterotomy or lithotripsy.