n. imaging of the bile ducts in order to demonstrate congenital anatomical abnormalities (such as biliary atresia), biliary diseases, and the presence of gallstones or strictures. It may be combined with imaging of the pancreatic duct (cholangiopancreatography), as in endoscopic retrograde cholangiopancreatography (see ERCP). Magnetic resonance cholangiopancreatography (MRCP) is a noninvasive *magnetic resonance imaging technique that has largely superseded ERCP for diagnostic purposes. ERCP following MRCP is used for therapeutic intervention. In operative (or on-table) cholangiography, a radiopaque *contrast medium is injected into the bile ducts during *cholecystectomy, to ensure that there are no remaining gallstones in the ducts. Percutaneous transhepatic cholangiography (PTC) is an invasive technique in which a catheter is manipulated under direct fluoroscopic guidance through the anterior abdominal wall, across the liver, and into a bile duct; contrast solution is injected to outline the bile ducts. Using a *Seldinger technique, drains or stents can be placed to treat infection or malignant strictures. T-tube cholangiography involves the postoperative injection of radiopaque contrast material via a drain (T-tube) left in the main bile duct after cholecystectomy.... cholangiography
weakness or paralysis of the shoulder and arm usually caused by injury to the upper roots of the *brachial plexus during traumatic childbirth. This may happen if, during a difficult delivery, excess traction applied to the head damages the fifth and sixth cervical roots of the spinal cord. The muscles of the shoulder and the flexors of the elbow are paralysed and the arm hangs at the side internally rotated at the shoulder with the forearm pronated (waiter’s-tip deformity). Recovery may be spontaneous, but in some cases nerve grafts or muscle transfers are required. [W. H. Erb (1840–1921), German neurologist]
ERCP (endoscopic retrograde cholangiopancreatography) the technique in which a catheter is passed through a *duodenoscope into the *ampulla of Vater of the common bile duct and injected with a radiopaque medium to outline the pancreatic duct and bile ducts radiologically. Magnetic resonance cholangiopancreatography (MRCP; see cholangiography) is often used to diagnose biliary and pancreatic disease followed by ERCP for diagnostic confirmation and therapeutic intervention. ERCP facilitates the removal of gallstones from the common bile duct, biopsy of lesions, and insertion of biliary *stents. See also papillotomy.... erb’s palsy
a congenital abnormality in which the pancreas develops in two parts draining separately into the duodenum, the small ventral pancreas through the main ampulla and the larger dorsal pancreas through an accessory papilla. In rare instances this is associated with recurrent abdominal pain, probably due to inadequate drainage of the dorsal pancreas. Diagnosis is made by CT imaging, magnetic resonance cholangiopancreatography (MRCP), or *ERCP.... pancreas divisum
n. a radiographic image of the pancreatic ducts obtained by injecting contrast material into them by direct puncture under ultrasound guidance. It has largely been replaced by noninvasive techniques involving MRCP (see cholangiography).... pancreatogram
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