Causes of Prominent CBD And Pancreatic Duct

by Valantino-Souza
(Calgary)

Hi.

I am 55 year old. I saw my family physician a few weeks ago because I get pain on my upper abdomen every now and then. The pain seems to come on after I eat.

He examined me, and said the problem my be with my gallbladder; maybe I have a gallstone. He sent me for an abdominal scan.

I received the result today and it says:

" The liver is diffusely echogenic consistent with fatty infiltration. No focal lesions seen. The gallbladder is normal in appearance with no evidence of calculi. The CBD is prominent at 8mm in diameter. There is no intrahepatic duct dilatation. The pancreas was difficult to visualize due to extensive bowel gas shaddowing in the epigastrium, but the pancreatic duct is at the upper limit of normal measuring 3mm in diameter. In view of the prominent CBD and pancreatic duct a mass in the ampulla cannot be excluded. Both kidneys are normal in size and appearances. The spleen is not enlarged.

Impression: Prominent CBD and Pancreatic duct ?cause."

What does this mean and what could be the cause of the problem. Does that mean I do not have gallstones?

Please help.

Valantino-Souza




Dear Valantino-Souza,

Causes of prominent CBD and pancreatic duct are usually due to conditions that cause obstruction down the end of the where the enlargement or ballooning occurs.
They include:
  • Ampulla of Vater stricture or tumour
  • Sphincter of Oddi dysfunction or stenosis
  • Sphincter of Oddi tumour
  • Stone trapped in the ampulla of Vater
  • Duodenal polyp impacting on the ampulla region.

The symptoms you described as well as the findings reported on your abdominal ultrasound scan suggests that you may actually be suffering with sphincter of Oddi dysfunction or a tumour in the ampulla of Vater.

I would suggest that you request that your family physician refer you to see a gastroenterologist of upper gastrointestinal surgeon for further assessment. What are your thoughts?

Please do not hesitate to contact us should you require any further info or help with list of specialists who are experts in this area.
Please let us know how you went.

Dr O Edema
Abdopain.com

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