Biliary Obstruction Questions & Answers

Updated: Oct 16, 2019
  • Author: Jennifer Lynn Bonheur, MD; Chief Editor: Vinay Kumar Kapoor, MBBS, MS, FRCS, FAMS  more...
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Questions & Answers

Overview

What is the normal function of the biliary tree?

What is biliary obstruction?

What are the pathophysiological mechanisms of biliary obstruction?

What is the pathophysiology of intrahepatic cholestasis in biliary obstruction?

What is the pathophysiology of extrahepatic biliary obstruction?

What is the pathophysiology of jaundice in biliary obstruction?

What are the effects of lack of bilirubin in the pathophysiology of biliary obstruction?

How are the causes of biliary obstruction categorized?

What are the intrahepatic causes of biliary obstruction?

How are extrahepatic causes of biliary obstruction further subdivided?

Which neoplasms cause biliary obstruction?

What is the role of stone disease in the etiology of biliary obstruction?

What are parasitic causes of biliary obstruction?

What is the role of primary sclerosing cholangitis (PSC) in the etiology of biliary obstruction?

What is the role of tuberculosis in the etiology of biliary obstruction?

What is the association between biliary obstruction and pancreatitis?

What is the role of IV feeding in the etiology of biliary obstruction?

What is Sump syndrome?

What is the incidence of biliary obstruction in the US?

What are the racial predilections of biliary obstruction?

How does the prevalence of biliary obstruction vary by sex?

What is the prognosis of biliary obstruction?

What are potential complications of biliary obstruction?

Presentation

What is the signs and symptoms of biliary obstruction?

What should be the focus of clinical history in the evaluation of biliary obstruction?

Which physical findings are characteristic of biliary obstruction?

DDX

When is double balloon enteroscopy (DBE) used in the evaluation of biliary obstruction?

What should be included in the differential diagnoses for biliary obstruction?

What are the differential diagnoses for Biliary Obstruction?

Workup

What serum bilirubin level findings suggest biliary obstruction?

What are serum bilirubin level findings suggestive of extrahepatic biliary obstruction?

What are serum bilirubin level findings suggestive of intrahepatic biliary obstruction?

What is the role of alkaline phosphatase (ALP) measurement in the workup of biliary obstruction?

What alkaline phosphatase (ALP) level findings exclude a diagnosis of extrahepatic biliary obstruction?

What are alkaline phosphatase (ALP) level findings suggestive of intrahepatic biliary obstruction?

What levels of serum transaminases suggest biliary obstruction?

What levels of serum transaminases suggest extrahepatic biliary obstruction?

What levels of serum transaminases suggest intrahepatic biliary obstruction?

What GGT levels suggest biliary obstruction?

What is the role of prothrombin time (PT) in the workup of biliary obstruction?

When is hepatitis serology indicated in the workup of biliary obstruction?

What is the role of antimitochondrial antibody testing in the workup of biliary obstruction?

What is the role of urine bilirubin testing in the workup of biliary obstruction?

What is the role of radiography in the workup of biliary obstruction?

What is the role of ultrasonography (US) in the workup of biliary obstruction?

What is the role of CT scanning in the workup of biliary obstruction?

What is the role of spiral CT scanning in the workup of biliary obstruction?

What is the advantage of magnetic resonance cholangiopancreatography (MRCP) for the evaluation of biliary obstruction?

What is the role of magnetic resonance cholangiopancreatography (MRCP) in the evaluation of biliary obstruction?

What is the role of endoscopic retrograde cholangiopancreatography (ERCP) in the workup of biliary obstruction?

What is the role of percutaneous transhepatic cholangiogram (PTC) in the workup of biliary obstruction?

What is the role of endoscopic ultrasound (EUS) in the workup of biliary obstruction?

Treatment

What are the treatment options for biliary obstruction?

What is the role of drug treatment for biliary obstruction?

What is included in medical care for biliary obstruction?

What is the role of surgery in the treatment of biliary obstruction?

What dietary and activity restrictions are required for the treatment of biliary obstruction?

How is biliary obstruction prevented?

Medications

Which medications are used in the treatment of biliary obstruction?

Which medications in the drug class Bile acid–binding resins are used in the treatment of Biliary Obstruction?

Which medications in the drug class Antibiotics are used in the treatment of Biliary Obstruction?

Which medications in the drug class Narcotic antagonists are used in the treatment of Biliary Obstruction?

Which medications in the drug class Gallstone solubilizing agents are used in the treatment of Biliary Obstruction?