Initial investigation of choice for biliary obstruction:
Correct Answer: USG
Description: Ref: Sabi Mon Textbook of Surgery, / 9th Edition,Pg: 1481.Explanation:UltrasoundInvestigation of choice for the initial evaluation of jaundice or symptoms of biliary disease.Sensitive, inexpensive. reliable. and reproducible test to evaluate most of the biliary treeDifferentiates patients with medical jaundice front those with surgical jaundiceHigh specificity and sensitivity for gallstones.) superior to CT)CELTCT can be used to identify the cause and site of biliary obstructionTriple-phase CT (Arterial phase. Portal venous phase, and Delayed phase) is invaluable in preoperative planning.Magnetic resonance imagingIt uses the water in bile to delineate the biliary tree and thus provides superior anatomic definition of the intrahepatic and extrahepatic biliary tree and pancreas.MRI is noninvasive, requires no radiation exposure, and can prove extremely useful when planning resection of biliary or pancreatic neoplasms or management of complex biliary pathology.By using the water content of bile, a cholangiopancreatogramtMRCP) can becreatedEndoscopic retrograde cholangiopancreatography (ERCP)Endoscopic retrograde cholangiopancreatography is an invasive test using endoscopy and fluoroscopy to inject contrast through the ampulla and image the biliary tree.In general ERCP is done when a therapeutic intervention is planned (Stone extraction in CBD stones/stenting for strictures) and not as a standalone diagnostic procedure.Percutaneous transhepatic cholangiography (PTC)It is an invasive procedure used to evaluate the biliary tree.Intrahepatic biliary radical dilatation is a prerequisite for performing PTC.A needle is passed directly into the liver to access one of the biliary radicals, and the tract is then used for insertion of transhepatic catheters.Useful for patients with intrahepatic biliary disease or in whom ERCP is not technically feasiblePTC can decompress biliary obstruction, stent obstructions nonoperatively, and provide anatomic information for biliary reconstruction
Category:
Surgery
Get More
Subject Mock Tests
Practice with over 200,000 questions from various medical subjects and improve your knowledge.
Attempt a mock test nowMock Exam
Take an exam with 100 random questions selected from all subjects to test your knowledge.
Coming SoonGet More
Subject Mock Tests
Try practicing mock tests with over 200,000 questions from various medical subjects.
Attempt a mock test now