[The role of bioimaging and interventional technics in the diagnostic and therapeutic management of jaundice].
Differential diagnosis between medical and surgical icterus is often difficult, if based on clinical data only. Echotomographic studies represent the first choice method between diagnostic imaging techniques. If a negative result is found (due to initial phase or an intermittent icterus) a new examination can be performed after few days; a scintigraphic study with HIDA can be also performed. If a positive result is found on echotomography, a CT scan can be performed and, if necessary, an ERCP or a TPC. MR imaging is an available technique to ameliorate the evaluation of lesion's extension and its relationship with adjacent vascular structures. Talking about therapeutic implications, we find quite useful to apply an endobiliar prosthesis during the first phase, in order to better understand the real extension of the lesion. Surgical treatment is justified, if a radical resection is possible and in all cases with a prognosis of over 6 months, because of the minor percentage of long time complications in traditional surgery with respect to interventional radiologic techniques.
Gualdi
G F
GF
Università degli Studi di Roma La Sapienza, I Clinica Medica, Servizio di TC e RM.
Volpe
A
A
Polettini
E
E
Trasimeni
G
G
Di Biasi
C
C
D'Amico
D
D
D001660:Biliary Tract Diseases / Q000150:complications / Q000175:diagnosis* / Q000601:surgery / Q000628:therapy; D001661:Biliary Tract Neoplasms / Q000150:complications / Q000175:diagnosis* / Q000601:surgery / Q000628:therapy; D002760:Cholangiopancreatography, Endoscopic Retrograde; D002763:Cholecystectomy; D002769:Cholelithiasis / Q000150:complications / Q000175:diagnosis / Q000601:surgery / Q000628:therapy; D003952:Diagnostic Imaging / Q000379:methods; D004322:Drainage; D006801:Humans; D007565:Jaundice / Q000175:diagnosis / Q000209:etiology* / Q000628:therapy; D008096:Lithotripsy; D008279:Magnetic Resonance Imaging; D010166:Palliative Care; D016717:Sphincterotomy, Endoscopic; D014057:Tomography, X-Ray Computed