title: Unexplained common bile duct dilatation with normal serum liver enzymes: diagnostic yield of endoscopic ultrasound and follow-up of this condition.
abstract: BACKGROUND
  There is scant literature about common bile duct (CBD) dilatation with normal liver function tests (LFTs).
  
  
  OBJECTIVE
  The aims of this study were to assess the diagnostic yield of endoscopic ultrasound (EUS) in patients with CBD dilatation, normal LFTs, and prior inconclusive imaging tests, and to assess the natural history of these subjects.
  
  
  METHODS
  We retrospectively reviewed our EUS database for patients referred for evaluation of CBD dilatation, normal LFTs, and prior inconclusive imaging. We excluded patients with a prior endoscopic retrograde cholangiopancreatography or a history of biliary obstruction, pancreatitis, or jaundice. Follow-up data were retrieved from medical records or by calling the general practitioners, referring specialists, patients, or their closest relatives.
  
  
  RESULTS
  A total of 57 patients were enrolled. The mean CBD diameter was 12.5±3.6 mm. The majority of patients (50.8%) were asymptomatic. Abnormal EUS findings were recorded in 12 (21%) subjects: 6 patients had a periampullary diverticulum, 2 had ampullary adenoma, 2 had signs of chronic pancreatitis, 1 had a cancer of the pancreatic head, and 1 had a 7 mm CBD stone. Neither age, sex, prior cholecystectomy, clinical presentation, CBD diameter, nor a dilated main pancreatic duct were predictors of abnormal EUS findings. None of the patients complained of biliary symptoms or showed abnormal LFTs on long-term follow-up.
  
  
  CONCLUSIONS
  CBD dilatation with normal liver chemistry is not always a benign condition. Even when prior imaging tests are negative, EUS may allow to diagnose conditions overlooked by standard diagnostic imaging.
authors.affiliation: *GastroHepatology Department †Laboratory Department, "San Giovanni Battista" Hospital, University of Turin ‡Laboratory Department, "Maria Vittoria" Hospital, Turin, Italy §Division of Gastroenterology and Hepatology, American University of Beirut School of Medicine, Beirut, Lebanon.
authors.forename: Mauro
authors.initials: M
authors.lastname: Bruno
authors.forename: Rosario F
authors.initials: RF
authors.lastname: Brizzi
authors.forename: Lavinia
authors.initials: L
authors.lastname: Mezzabotta
authors.forename: Patrizia
authors.initials: P
authors.lastname: Carucci
authors.forename: Chiara
authors.initials: C
authors.lastname: Elia
authors.forename: Silvia
authors.initials: S
authors.lastname: Gaia
authors.forename: Giulio
authors.initials: G
authors.lastname: Mengozzi
authors.forename: Alessandrina V
authors.initials: AV
authors.lastname: Romito
authors.forename: Mohamad A
authors.initials: MA
authors.lastname: Eloubeidi
authors.forename: Mario
authors.initials: M
authors.lastname: Rizzetto
authors.forename: Claudio
authors.initials: C
authors.lastname: De Angelis
mesh_terms: D000368:Aged; D003137:Common Bile Duct Diseases / Q000175:diagnosis* / Q000503:physiopathology; D016208:Databases, Factual; D019160:Endosonography / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008099:Liver / Q000201:enzymology*; D008111:Liver Function Tests; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies