Common Bile Duct Dilation With Unknown Cause in Bowel Obstruction Patients

Abstract

Common bile duct (CBD) dilation is detected in many patients, both symptomatic and asymptomatic. It can be challenging to diagnose unexplained dilated CBD. The purpose of this study was to investigate the causing factors of CBD dilation in bowel obstruction and their relationship to one another. The prospective cross-sectional study included patients with bowel obstruction referred to two tertiary referral hospitals between 2019 and 2021. All patients in the emergency unit were examined by colorectal surgeons, and they were given IV and oral contrast-enhanced CT scans. We included patients with a dilated common bile duct and bowel obstruction. After that, we determined the causes of CBD dilatation in patients with obstruction. In cases without a specific cause, we investigated its relationship to the bowel loop diameter. Of 226 patients with intestinal obstruction referred to our hospital, 97 underwent CT scans of the abdomen, of which 35 (36%) had dilated CBDs. The mean age of the patients was 58±13 years; 66% of patients were male. CBD dilatation was commonly associated with aging (18 cases, 51%), addiction (4 cases, 11%), and cholecystectomy (3 cases, 9%). A CT scan showed dilated CBD in eight patients (23%) without a specific cause. CBD diameter and, sex did not differ significantly. Patients with unknown causes have a mean bowel diameter of 53.75±11.97 mm. CBD diameter correlated considerably with bowel diameter (P=0.001). This cross-sectional study suggests a possible association between CBD and bowel loop dilation, rather than establishing a cause-and-effect relationship.