Biliary tract obstruction is a common clinical problem. The biliary tract is the path by which bile is released by the liver and taken to the small intestine. The most common causes of biliary tract obstruction are gallstones and cancerous tumours. Less common causes include inflammation of the pancreas, metastatic disease to the liver and a disease of the bile ducts that causes inflammation and obstruction.
Patients often experience symptoms such as fever, abdominal pain in the upper right side, jaundice and nausea. Less frequent symptoms include itching and vomiting.
The most common symptoms are intermittent muscle pain and cramps, a continuous burning pain in the leg, numbness and pain caused by nerve damage, chest pain, high blood pressure and symptoms related to stroke.
Specific blood tests can usually rule out certain conditions, such as an inflammation of the gallbladder, infection of the bile duct and an increased level of waste product from the liver, liver enzymes, and alkaline phosphatase. Any of these may indicate a loss of bile flow. Several imaging techniques, including ultrasound, MRI and CT, can be used to diagnose biliary duct obstruction.
Treatments for biliary duct obstruction include surgery, imaging and interventional radiology. An interventional radiologist may perform a biliary dilation through the skin and insert a stent, a small mesh tube, which can offer security in the management of biliary obstructions.