[Echographic diagnosis of calculous lesions of the bile ducts]

The author presented methods and results of ultrasonic diagnosis of concrements in intrahepatic (4), lobar (5), cystic (24) and common bile (20) ducts. In technically difficult cases the starting point of an acoustic shadow route was the only sign permitting concrement localization in the duct. Indirect signs of occluding choledocholithiasis were dilatated lumen of intrahepatic and proximal (with respect to the site of occlusion) extrahepatic ducts, a concrement filled cavity and the tense gall bladder wall, the absence of echographic signs of tumor involvement of the peritoneal cavity organs. The dilatation of the ducts and gall bladder cavity were more noticeable in patients with a long history of cholestasis. The lamination of the gall bladder content into zones of different echogenicity, the filling of the dilatated ducts with the content of inhomogeneous acoustic transparency indicated the complication of occluding choledocholithiasis by purulent cholangitis.