Non dilatancy

In the case of non-dilated bile ducts, further specific laboratory parameters may be necessary for differential diagnosis, such as electrophoresis, immunoglobulins, hepatitis serology (s. p. 116) and tti-foetoprotein (s. p. 106). Determination of the AMA should always be considered. (s. p. 120) (s. tabs. 5.19-5.21 13.7)... 

If definitive clarification of cholestasis has still not been reached (even with MRC imaging), dilated bile ducts indicate an ERC or, if this is technically impossible, a PTC. The diagnostic sensitivity is 60-70%, the specificity 90-95 (-100)%. The ERC should also be used to visualize non-dilated bile ducts by means of direct presentation - e.g. in cases with suspicion of destructive primary biliary or sclerosing cholangitis as well as regionally restricted intrahepatic obstruction, (s. figs. 8.12, 8.13) (s. tab. 13.9)... 

Fig. 5.6a,b. Paraduodenal internal hernia, a Oblique scan above the umbilicus shows the zone of transition (arrow) between dilated and non-dilated bowel, b Transverse scan to the left of zone of transition shows the cluster of crowded and compressed loops of bowel as if they are tightly packed within a sac (arrows)... 

The European soil classification system distinguishes very coarse materials (boulders and cobbles) as those in which most particles are retained on a 63 mm sieve, coarse materials (gravels and sands) as those in which most particles are retained on a 0.063 mm sieve and fine soil materials as those with low plasticity and are dilatant (silts) or those that are plastic and non-dilatant (clays). 

Funaki B, Zaleski GX, Straus CA, Leef JA, Funaki AN, Lorenz J, Farrell TA, Rosenblum JD (2000) Percutaneous biliary drainage in patients with non-dilated intrahepatic bile ducts. AJR Am J Roentgenol 175 268 Gabelmann A, Hamid H, Brambs HJ et al (2001) Metallic stents in benign biliary strictures long-term effectiveness and interventional management of stent occlusion. AJR Am J Roentgenol 177 813 17... 

These include ulcers in the distal duodenum, the presence of a double pyloric canal (Fig. 5.8b,c), or multiple recurrent anastomotic ulcers. Other findings include a non-dilated non-obstructed stomach filled with diluted barium due to hypersecretion, dilatation of the duodenum and proximal small bowel, sluggish gastric peristalsis, and thickening of gastric and duodenal folds (Berg and Wolfe 1991 Hirschowitz 1997). 

---