Original Articles

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.

1. Komut E. Extraspinal incidental findings and reporting rates at lumbar spine magnetic resonance imaging: more than a spinal examination? J Heal Sci Med 2021;4:582–588.
2. Khasawneh RA, Mohaidat Z, Khasawneh FA, et al. Extraspinal findings prevalence and clinical significance in 4250 lumbar spine MRI exams. Sci Rep 2021;11:1–11.
3. Tuncel SA, Çaglı B, Tekataş A, et al. Extraspinal incidental findings on routine MRI of lumbar spine: Prevalence and reporting rates in 1278 patients. Korean J Radiol 2015;16:866–873.
4. Fu CJ, Chen HW, Wu C, et al. Extraspinal malignancies found incidentally on lumbar spine MRI: Prevalence and etiologies. Chinese J Radiol 2013;38:85–91.
5. Lee SI, Dreyer KJ, Thrall JH, et al. When Does a Radiologist ’s Recommendation for Follow-up Result in High-Cost Imaging? Radiology 2012;262:544–549.
6. Oppong KW, Mitra V, Scott J, et al. Endoscopic ultrasound in patients with normal liver blood tests and unexplained dilatation of common bile duct and or pancreatic duct. Scand J Gastroenterol 2014;49:473–480.
7. Lal N, Mehra S, Lal V. Ultrasonographic measurement of normal common bile duct diameter and its correlation with age, Sex and anthropometry. J Clin Diagnostic Res 2014;8:01–04.
8. Bachar GN, Cohen M, Belenky A, Atar E, Gideon S. Effect of aging on the adult extrahepatic bile duct: a sonographic study. J Ultrasound Med 2003;22:9:879-82.
9. Saluja SS, Varshney VK, Bhat VS, et al. Management of Obscurely Dilated Common Bile Duct with Normal Liver Function Tests: A Pragmatic Approach. World J Surg 2021;45:2712–2718.
10. Bruno M, Brizzi RF, Mezzabotta L, et al. Unexplained common bile duct dilatation with normal serum liver enzymes: Diagnostic yield of endoscopic ultrasound and follow-up of this condition. J Clin Gastroenterol 2014;48:67–70.
11. Chhoda A, Dawod S, Grimshaw A, et al. Evaluation of diagnostic yield of EUS among patients with asymptomatic common bile duct dilation: systematic review and meta-analysis. Gastrointest Endosc 2021;94:890-901.
12. Krishna NB, Tummala P, Mehan CD, et al. Isolated and unexplained dilation of the common bile duct on computed tomography scans. Gastroenterol Insights 2012;4:63–68.
13. Smith I, Monkemuller K, Wilcox CM. Incidentally identified common bile duct dilatation: A systematic review of evaluation, causes, and outcome. J Clin Gastroenterol 2015;49:810–815.
14. Nadarajah V, Eynon A, Martin D. Small Bowel Obstruction and Associated Common Bile Duct Dilatation. RSNA 2007; Annual meeting.
15. Malik S, Kaushik N, Khalid A, et al. EUS yield in evaluating biliary dilatation in patients with normal serum liver enzymes. Dig Dis Sci 2007;52:508–512.
16. Kwok A, Lau J, Brian Jones D. Role of Endoscopic Ultrasound in Evaluation of Unexplained Common Bile Duct Dilation. Gastrointest Endosc 2009;69:250-251.
17. Rana SS, Bhasin DK, Sharma V, et al. Role of endoscopic ultrasound in evaluation of unexplained common bile duct dilatation on magnetic resonance cholangiopancreatography. Ann Gastroenterol 2013;26:66–70.
18. Kim JE, Lee JK, Lee KT, et al. The clinical significance of common bile-duct dilatation in patients without biliary symptoms or causative lesions on ultrasonography. Endoscopy 2001;33:495–500.
19. Jeon J, Song SY, Lee KT, et al. Clinical significance and long-term outcome of incidentally found bile duct dilatation. Dig Dis Sci 2013;58:3293–3299.
20. Nuño-Guzmán CM. Gallstone ileus, clinical presentation, diagnostic and treatment approach. World J Gastrointest Surg 2016;8:65.
21. Van Der Spek BW, Cuesta MA, Jacobs MA. A patient with biliary colic and intestinal obstruction. Gut 2012;61(14):2010-2.
22. Kim Y, Choi D, Choi S, et al. Biliary phytobezoar resulting in intestinal obstruction. World J Gastroenterol 2013;19(1):133-136.
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IssueVol 64 No 8 (2026) QRcode
SectionOriginal Articles
Keywords
Common bile duct Asymptomatic diseases Intestinal obstruction Multidetector computed tomography Ultrasonography
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How to Cite
1.
Movahed S, Mashhadi A, Maleknejad A, Mashhadi M, Hoseinian M, Masoodian S, Zadehmir M. Common Bile Duct Dilation With Unknown Cause in Bowel Obstruction Patients. Acta Med Iran. 2026;64(8):482-488.