Intrahepatic bile duct stones B-ultrasound manifestations

Written by Shen Jiang Chao
Radiology
Updated on September 01, 2024
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Intrahepatic bile duct stones show typical sonographic changes on ultrasound, appearing as punctate or mass-like strong echoes within the liver, accompanied by acoustic shadows. These strong echoes are distributed along the intrahepatic bile ducts. The bile duct proximal to the stone may exhibit varying degrees of dilation, and the dilated intrahepatic bile duct, along with the accompanying portal vein, forms a parallel tube sign. Around the strong echoes of the stones, a narrow anechoic region can be seen encircling them, and the stones generally do not move with changes in body position. Intrahepatic bile duct stones can also cause thickening of hepatic parenchyma echoes and internal echo heterogeneity.

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Written by Zhang Tao
Hepatobiliary Surgery
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What medicine should be taken for intrahepatic bile duct stones?

The treatment of intrahepatic bile duct stones currently does not have specific medications. Traditional Chinese medicine treatments primarily focus on clearing the liver and facilitating bile flow, and have certain clinical effects. Western medicine often uses deoxycholic acid, ursodeoxycholic acid, and chenodeoxycholic acid, which can somewhat prevent the formation of bile duct stones. It is also recommended that patients change poor lifestyle habits, adjust their life rhythms, and eat three meals a day at regular times, especially breakfast. Specific medications should be used under the guidance of a doctor.

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Written by Liu Wu Cai
Hepatobiliary Surgery
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Is dandelion useful for intrahepatic bile duct stones?

Dandelion has no effect on intrahepatic bile duct stones. For patients with intrahepatic bile duct stones, if the stones are small, generally there are no obvious symptoms at this time, and no special treatment is needed. It is possible to periodically review with color ultrasound to dynamically observe the change in size. Of course, spicy and irritating foods should be avoided in the usual diet to reduce inflammatory stimulation, and eating more fresh vegetables and fruits can better control the development of the condition. For patients with larger intrahepatic bile duct stones, there might be complications such as acute cholangitis, characterized by severe pain and jaundice. Therefore, in such severe cases, early surgical treatment should be considered.

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Written by Liu Wu Cai
Hepatobiliary Surgery
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Can liver intrahepatic bile duct stones be detected by ultrasound?

Patients with intrahepatic bile duct stones can be detected via ultrasound examination, where the stones are clearly visible, especially for those with larger stones. These patients may also experience recurrent right upper abdominal pain, nausea, and vomiting. For patients with intrahepatic bile duct stones who exhibit significant symptoms, it is advisable to undergo surgical treatment as soon as possible. Only by surgically opening the bile duct and removing the stones can a cure be achieved. However, if the stones are relatively small and asymptomatic, they might not be detected during an ultrasound examination, and no special treatment is required at that time. If small gallstones are observed, it is recommended to regularly recheck with an ultrasound to monitor changes in size.

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Written by Liu Wu Cai
Hepatobiliary Surgery
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Will running cause pain if there are stones in the bile ducts within the liver?

Patients with intrahepatic bile duct stones may experience pain while running. For patients with intrahepatic bile duct stones, symptoms often worsen after vigorous activities. These patients frequently also suffer from cholangitis, which can cause significant pain in the upper right abdomen, along with clinical symptoms such as jaundice, nausea, vomiting, chills, and high fever, especially after consuming greasy food or overeating combined with intense activity. Therefore, it is advisable to seek surgical treatment as soon as possible. The main surgical method is laparoscopic choledochotomy for stone removal, which can achieve better treatment outcomes after the stones are extracted.

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Written by Li Hu Chen
Imaging Center
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Ultrasound presentation of intrahepatic bile duct stones

Intrahepatic bile duct stones can generally be detected via ultrasound, as they show up as strong echoes due to their solid nature which reflects sound waves back to the surface. However, the majority of these intrahepatic bile duct stones are asymptomatic. Since they rarely cause dilation of the intrahepatic bile ducts, and as long as the bile ducts do not appear dilated, thickened, or tortuous on the ultrasound, they usually do not have any significant impact. Therefore, most intrahepatic bile duct stones do not require treatment and can be managed through observation.