Pre-hospital detection of intrahepatic biliary duct dilatation: Recognizing the abundance of vessels in the liver

Miravent, Sérgio; Lobo, Manuel Duarte; Almeida, Rui

http://hdl.handle.net/10400.1/26680

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Authors

Miravent, Sérgio

Lobo, Manuel Duarte

Almeida, Rui

Abstract(s)

Diagnosing and confirming intrahepatic biliary duct dilation (IHBDD) involves a coordinated effort across multiple medical spe cialties, often relying on comprehensive blood analysis. However, the utility of screening ultrasound in detecting intrahepatic biliary dilation becomes particularly valuable in pre-hospital settings like our Basic Emergency Service, especially when access to alternative imaging techniques or detailed blood analyses are unavailable. Detecting the intrahepatic biliary dilation pattern through ultrasound is notably straightforward for a skilled sonographer. The presence of IHBDD can be efficiently identified during a screening ultrasound, allowing identifi cation of imaging findings that help differentiate simple biliary colic from clinical cases that should be prompt referral to the reference hos pital and without unnecessary delays or resource expenditure. The eti ology of IHBDD is multifactorial1 , and while its presentations may vary, the characteristic ultrasound pattern often involves the visualization of “extra vessels within the liver,” related to the distinctive “shotgun” sign2 . This sign translates into the observation of dilated bile ducts exhibiting no flow on Doppler imaging.