Cholangitis ultrasound

Ultrasounds are the primary imaging modality for cholangitis. An ultrasound is both sensitive and specific in demonstrating biliary dilatation.

An ultrasound is the primary imaging modality used to access patients with suspected acute cholangitis.^[1] Ultrasounds may show dilation of the bile duct and identifies 38% of bile duct stones.^[2]

• Ultrasounds are relatively poor at identifying stones further down the bile duct, but they are both sensitive and specific in detecting biliary dilatations.
• An ultrasound can show biliary dilatations with or without stones and debris material within the common bile duct.^[3]
  • However, biliary dilatations are not always present at early stages of bile duct obsctructions, and the performance of an ultrasound in demonstrating choledocholithiasis is poor.^[1]
• For patients who have previously not undergone a cholecystectomy, an ultrasound is helpful to determine the probability of choledocholithiasis, even if the stone is not directly visible.^[1]
• The main finding of ascending cholangitis on an ultrasound is the thickening of the bile duct walls.^[3]

• Ultrasound can help distinguish between cholangitis and cholecystitis (inflammation of the gallbladder), which has similar symptoms to cholangitis, but appears differently on ultrasound.^[2]

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