A patient has a surgical cause of obstructive jaundice. USG can tell all of the following except:
**Core Concept:** Ultrasound (USG) is the first-line imaging modality for obstructive jaundice, capable of detecting biliary dilation, gallstones, and pancreatic masses. However, it has limitations in visualizing the distal common bile duct and small intrahepatic lesions.
**Why the Correct Answer is Right:** USG cannot reliably identify **distal common bile duct stones** due to overlying bowel gas and poor acoustic window. It also fails to visualize the ampulla of Vater or small intrahepatic duct strictures. Contrast-enhanced CT or MRCP is required for these cases.
**Why Each Wrong Option is Incorrect:**
**Option A:** "Detect intrahepatic bile duct dilation" β USG excels at identifying dilated intrahepatic ducts due to its high sensitivity for biliary tree visualization.
**Option B:** "Identify gallbladder stones" β USG is the gold standard for diagnosing cholelithiasis.
**Option C:** "Assess pancreatic head mass" β USG can detect pancreatic enlargement or hypoechoic masses compressing the bile duct.
**Clinical Pearl / High-Yield Fact:** Remember: **USG is excellent for biliary tree dilation but poor for distal common bile duct details**. Always follow-up with MRCP or ERCP for definitive diagnosis of distal biliary obstruction.
**Correct Answer: D. Detect distal common bile duct stones**