• Title/Summary/Keyword: Bile ducts

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Anatomical studies on pattern of branches of bile and hepatic ducts in Korean native cattle (한우의 담관 및 간관의 분지에 관한 해부학적 연구)

  • Kim, Chong-sup
    • Korean Journal of Veterinary Research
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    • v.34 no.1
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    • pp.1-7
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    • 1994
  • The distribution of the bile and hepatic ducts within the liver of 24 Korean native cattle were observed. Vinylite solution was injected into common bile ducts on 13 cases for cast preparation. The angiography was prepared in 11 cases which were injected 30% barium sulfate solution into the common bile ducts and then radiographed on X-ray apparatus. The results were summarized as follows; 1. The dorsal, intermediate and ventral ducts of left hepatic lobes, ducts of quadrate lobes, and ducts of papillary process were collected into left hepatic ducts. The dorsal and ventral ducts of right hepatic lobe, ducts of caudate process and papillary process were collected into right hepatic ducts. 2. The bile ducts in the left hepatic lobes were collected into dorsal, ventral and intermediate ducts of left hepatic lobes. The intermediate ducts of left hepatic lobes was absent in some cases(5 cases, 20.83%). 3. In some cases, the ventral ducts of right hepatic lobes were collected into right hepatic ducts directly. 4. The ducts of quadate lobes were collected into left hepatic ducts(8 cases, 33.33%), ventral ducts of left hepatic lobes(13 cases, 54.17%), and dorsal duct of left hepatic lobes, intermediate and ventral ducts of left hepatic lobe, common trunk collected into intermediate and ventral duct of left hepatic lobe and left hepatic duct(1 cases, 4.17%) respectively. 5. The ducts of papillary process were collected into left and right hepatic ducts(12 cases, 50%), left hepatic ducts only(11 cases, 45.83%) or right hepatic duct only(1 cases, 4.17%). 6. The average length of right hepatic ducts was 26.87(6-45.8)mm. The average length of left hepatic ducts was 56.68(6-127)mm. The length of gallbladder was 128.60(104-160)mm on the average. The breadth of gallbladder was 67.16(38.4-153.4)mm on the average. But there was a difference in the length and the breadth according to the quantity of bile. 7. The ramified angles of dorsal, intermediate and ventral ducts of left hepatic lobes, ducts of quadrate lobes, ducts of papillary processes and caudate processes, dorsal and ventral ducts of right hepatic lobes and cystic ducts were 130-170, 160-200, 190-250, 240-300, 90-140, 320-350, 30-100, 270-330 and 240-300 degrees respectively.

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A Case of Spontaneous Resolution of Bile Plug Syndrome in a 4-year-old Girl (4세 여아에서 자연 완해된 담즙 마개 증후군 1례)

  • Jee, Keum-Bong;Song, Jun-Young;You, Ki-Yang;Min, Ki-Sik;Kim, Deok-Ha;Lee, Kwan-Seop
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.2 no.2
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    • pp.262-266
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    • 1999
  • Obstruction of the extrahepatic bile ducts is the most common cause of conjugated hyperbilirubinemia in early infancy. More than 90% of such obstructive lesions are accounted for by extrahepatic biliary atresia. A rare lesion is obstruction of the common duct by impacted, thickened secretions and bile. Bile plug syndrome is defined as extrahepatic obstruction of the bile ducts by bile sludge in term infants without anatomic abnormalities, congenital chemical defects of bile, or hepatocellular lesions. Obstruction of extrahepatic ducts by plugs of biliary material apperas to be due to the inspissation and precipitation of bile and mucus within the lumen of the ducts. Cholestasis and precipitation of bile develop in association with abnormal composition of bile in cystic fibrosis, hepatocellular damage, prolonged erythroblastic jaundice, altered biliary dynamics with total parenteral nutrition, gut dysfunction, diuretic therapy, exchange transfusions and perinatal hemolysis. In those cases, the term inspissated bile syndrome is used. The clinical and laboratory findings in bile plug syndrome are identical to those observed in biliary atresia and choledochal cyst. The diagnosis can be suspected based on the findings of clinical and laboratory examinations together with hepatobiliary imaging, ultrasonography, radionuclide scan and liver biopsy. We experienced a case of spontaneous resolution of bile plug syndrome in a 4-year-old girl. We report this case with brief review related literatures.

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A Study of Technical Approach Methods to Transabdominal Ultrasonography of the Extrahepatic Bile Ducts and of Following Effects from the Scan Training (간외담관 초음파검사의 주사방법 개선과 교육 후 주사 습득효과에 관한 연구)

  • Lee, In-Ja;Kang, Dae-Hyun;Kim, Bo-Young
    • Journal of radiological science and technology
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    • v.31 no.2
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    • pp.149-159
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    • 2008
  • The purposes of this study are to analyze abnormal dilatation of the extrahepatic bile ducts by using transabdominal ultrasound, to confirm the existence of bile ducts diseases and their interrelationship, and for it to give a new theoretical basis for the technical access to extrahepatic bile ducts, upon which to analyze the ripple effects of the scan training. After teaching technical access process based on the new theory about extrahepatic bile duct to the thirty students who are studying ultrasonography, we allocated three hours per one student (30 mins ${\times}$ 6 times) to focus on the training of scanning skill. Training has been performed by one-to-one method. For evaluation, all the students have to perform the scans on (1) confluence of the right and left hepatic ducts (extrahepatic bile ducts and cystic duct), (2) the suprapancreatic bile duct, (3) the intrapancreatic bile duct, (4) intrapapilla Duct, based on the clearly divided concept. The existing training and methods have had low confidency about transabdominal ultrasonography of the extrahepatic bile duct and had limitation with which they could image only the suprapancreatic bile duct. The evaluation after finishing the train based on the new theory, however, all the students (30students) can access to (1) confluence of the right and left hepatic ducts(extrahepatic bile ducts and cystic duct), (2) the suprapancreatic bile duct objectively. 24 students can access to (3) the intrapancreatic bile duct and only one student can even make an image for (4) the intrapapilla Duct Though the evaluation on extrahepatic bile duct has to be performed with multi-sided method considering intrahepatic cause, bile duct cause and pathophysiological cause, only if we can image the extrahepatic bile duct to ampular of Vater objectively and confidently, we can greatly reduce invasive procedure such as ERCP, which is for the purpose of simple differential diagnosis and painful to the patients. Therefore if we concentrate on the scanning train based on the new theory to raise the confidency about ultrasonography, the effect will be doubled.

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Imaging diagnosis of clonorchiasis

  • Choi, Don-Gil;Hong, Sung-Tae
    • Parasites, Hosts and Diseases
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    • v.45 no.2 s.142
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    • pp.77-85
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    • 2007
  • Among several diagnostic tools for clonorchiasis (Clonorchis sinensis infection), radiologic examinations are commonly used in clinical practices. During the 2 past decades, many reports regarding imaging findings of clonorchiasis were introduced. The basic imaging finding of clonorchiasis is diffuse dilatation of the peripheral intra-hepatic bile ducts, without dilation of the large intrahepatic or extrahepatic bile ducts. By this finding, however, active clonorchiasis cannot be differentiated from cured infection. Some recent radiologic studies suggested specific findings of active clonorchiasis. Besides direct demonstration of worms, increased periductal echogenicity on sonography and periductal enhancement on dynamic contrast-enhanced CT or MR imaging possibly represent active clonorchiasis. Those images of the liver clonorchiasis are known to be correlated with worm burdens (EPG counts) in their frequency and also severity. The images of cholangiocarcinoma associated with clonorchiasis show both the tumor with obstruction images and diffuse dilatation of the peripheral intrahepatic bile ducts. Radiological images can be a good practical alternative diagnostic method of clonorchiasis.

Biliary Ascariasis: MR Cholangiography Findings in Two Cases

  • Cheol Mok Hwang;Tae Kyoung Kim;Hyun Kwon Ha;Pyo Nyun Kim;Moon-Gyu Lee
    • Korean Journal of Radiology
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    • v.2 no.3
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    • pp.175-178
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    • 2001
  • We describe the imaging features of two cases of biliary ascariasis. Ultrasonography and CT showed no specific abnormal findings, but MR cholangiography clearly demonstrated an intraductal linear filling defect that led to the correct diagnosis. MR cholangiography is thus a useful technique for the diagnosis of biliary ascariasis.

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Turnover of biliaiy epithelial cells in Clonorchis sinensis infected rats (간흡충에 감염된 흰쥐 담관 상피세포의 증식 양상)

  • 홍성태;고원규
    • Parasites, Hosts and Diseases
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    • v.31 no.2
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    • pp.83-90
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    • 1993
  • We performed bromodeoxyuridine (BrdU) staining to observe the proliferation pattern of epithelial cells on the biliaJy mucosa in Clonorchis sinensis infection. Albino rats were infected with 100 metacercariae each and their livers were processed for histopathological observation after BrdU injection. Five to six sites in the liver of a rat were selected for paraffin section, and stained immunohistochemically to visualize BrdU incorporating cells. The flukes were mainly in the common bile duct and right or left hepatic bile ducts. The proportion of stained epithelial cells in the infected bile ducts where the worms were found on the section was 2.9-10.2% at 1 week after infection. 7.3-12.8% at 2 weeks, 7.3-13.4% at 5 weeks, and 8.4-14.8% at 15 weeks while in the non-infected ducts o to 2.7% cells were stained. The stained cells were mainly at the base of the mucosal layer. It is suggested that mucosal epithelial cells of the bile ducts infected with C. sinensis become hyperplastic mainly by direct and local stimulation of the worms.

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Studies on the artificial infection and the hematological change with Fasciola hepatica metacercariae in rats (흰쥐에 대(對)한 간질피낭유충(肝蛭被囊幼蟲)의 인공감염(人工感染)과 혈액상(血液像)에 관(關)한 연구(硏究))

  • Kang, Seung-won
    • Korean Journal of Veterinary Research
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    • v.34 no.3
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    • pp.549-557
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    • 1994
  • This study was done to find the method of the extermination of Fasciola hepatica matacercariae. And the artificial infection was carried out with 30 metacercarae exposed to 5% ammonia water and not-exposed to 5% ammonia water. Serial determinations of live weight, red blood cell, hemoglobin, packed cell volume, and eosinophils were performed in rats at 7 days interval for 16 weeks after infection (WAI). Recovery of worm burden and microscopic findings of livr was performed in rats at 10 WAI. The results in this work were summarized as follows; 1. Fasciola spp metacercariae exposed to 5% ammonia water have lost their ability of infection. 2. In teh exposed group, the mean of worm recovered was 2.25 and the common bile duct was swelling up to 0.71cm in diameter. 3. The value of live weight was different in two groups as the not-exposed group and the exposed group were 321.28, 384.38 at 10 WAI, respectively. 4. In the not-exposed group, at 7 WAI, hemoglobin at 5 WAI and packed cell volume at 7 WAI wre minimally decreased to $5.84{\times}10^{-6}/mm^3$, 11.53g/dl and 43.2%, respectively. But those three values were slowly increased at 10 WAI. Rercent cosinophil was increased to 12.2% at 4 WAI and slightly decreased to 7.9% at 10 WAI. But there are no stastistical singnificance between the exposed group and the normal control group. 5. In histolgical findings in the not-exposed group, the dilated common bile ducts and intrahepatic bile ducts showed distinct hyperplasia of the epithelium. Lymphocytes and eosinophils were infilterated around the bile ducts. The hepatic cells and Kupffer cells showed swollen appearance.

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A Case of Alagille Syndrome (Alagille 증후군 1례)

  • Kim, Eun-Soo;Lee, Dong-Woo;Chung, Ki-Sup;Kim, Soon-Il;Park, Young-Nyun
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.5 no.2
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    • pp.192-198
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    • 2002
  • Alagille syndrome is characterized by paucity of interlobular bile ducts, chronic cholestasis, characteristic facial abnormalities, cardiovascular abnormalities, posterior embryotoxon, vertebral arch defects, skeletal abnormalities, and glomerular renal involvement. We experienced a case of Alagille syndrome in a 10 month-old male presenting with jaundice. He had chronic cholestasis, characteristic face, cardiovascular abnormalities (aortic stenosis, dextrocardia, double chamber of left ventricle), and situs inversus. Histological examination of liver biopsy specimen revealed paucity of interlobular bile ducts with septal fibrosis, cirrhotic transformation and severe cholestasis. He underwent liver transplantation, but died of cardiopulmonary arrest associated with cardiac anomaly.

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Biliary Atresia (담도폐쇄)

  • Han, Seok-Joo
    • Advances in pediatric surgery
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    • v.17 no.1
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    • pp.1-14
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    • 2011
  • Biliary atresia (BA) is an infantile cholestatic disease of progressive obliterative cholangiopathy with varying degrees of damage to both extra and intrahepatic bile ducts due to unknown causes. The diagnostic studies should be done to diagnose or exclude BA without unnecessary delay. Kasai portoenterostomy is the first choice of treatment for bile drainage from microscopic bile ductules present in the portal fibrous mass. The medical management after Kasai portoenterostomy should be done carefully to maintain bile excretion and prevent and treat complications Including cholangitis, hepatic fibrosis, portal hypertension and nutritional problem. The reported five years-survival rates after Kasai portoenterostomy range from 30 to 60 %. About 20 % of all patients undergoing Kasai portoenterostomy during infancy survive into adulthood with their native liver. Even if Kasai portoenterostomy remains as the first line of treatment In BA, liver transplantation serves as a good salvage treatment when portoenterostomy fails or liver function gradually deteriorates after initially successful establishment of bile flow, Overall 5-year survival rate in BA is about 90 % in recent series.

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Extrahepatic Bile Duct Duplication with Intraductal Papillary Neoplasm: A Case Report (이중 담관 기형과 동반된 담관 관내 유두종 : 증례 보고)

  • Gayoung Jeon;Juwan Choi
    • Journal of the Korean Society of Radiology
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    • v.82 no.4
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    • pp.964-970
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    • 2021
  • Extrahepatic duct duplication is an extremely rare congenital anomaly. Hilar cholangiocarcinoma with extrahepatic bile duct duplication was reported; however, intraductal papillary neoplasm of the bile duct (IPNB) with extrahepatic bile duct duplication has not been reported to the best of our knowledge. We report a rare case of IPNB with extrahepatic bile duct duplication of a 64-year-old female. The patient underwent extended right hepatectomy, and the results of a subsequence histopathological examination were consistent with an IPNB with extrahepatic bile duct duplication. We report this rare case with radiologic imaging findings and a brief review of the current literature.