Recurrent pyogenic cholangitis: ultrasound evaluation compared with endoscopic retrograde cholangiopancreatography

Fifty cases of recurrent pyogenic cholangitis among Chinese in Hong Kong were studied by ultrasound and compared with endoscopic retrograde cholangiopancreatography. The sensitivity of ultrasound detection of both dilated intrahepatic biliary ducts and intrahepatic calculi is 67% as compared with endoscopic retrograde cholangiopancreatography. A negative study, therefore, does not rule out the presence of such pathological features. A dilated common duct is present in virtually every case of recurrent pyogenic cholangitis and ultrasound is very accurate in its detection. Furthermore, ultrasound is able to provide additional information which can be missed with endoscopic retrograde cholangiopancreatography. Prominent periportal echogenicity, concomitant abscesses and tumours are examples in this series. Such findings bear significance on the management of patients with recurrent pyogenic cholangitis.