Biliary tract dilatation in the nonjaundiced patient

The significance of intra- or extrahepatic biliary distension (or both) in 33 anicteric patients was investigated. The entire biliary tree and pancreas were sonographically evaluated. Correlation with the biochemical profile, cholangiography, endoscopy, and surgery were obtained when available. Fourteen patients had common bile duct stones, nine had partially obstructing masses, four had papillary stenosis, and three had common bile duct strictures. Two postcholecystectomy patients had dilatation without obstruction. Two patients had mild intrahepatic biliary tract distension without other evidence of biliary tract disease. Sonography is a more sensitive indicator of partial obstruction of the biliary tract than the serum bilirubin. If biliary distension exists, further investigation is warranted, unless an obstructing lesion is clearly defined by the sonogram.