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The effect of the Valsalva maneuver on the diameter of the common hepatic duct in extrahepatic biliary obstruction
Author(s) -
Quinn R J,
Meredith C,
Slade L
Publication year - 1992
Publication title -
journal of ultrasound in medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.574
H-Index - 91
eISSN - 1550-9613
pISSN - 0278-4297
DOI - 10.7863/jum.1992.11.4.143
Subject(s) - medicine , valsalva maneuver , common hepatic duct , endoscopic retrograde cholangiopancreatography , duct (anatomy) , common duct , ultrasonography , common bile duct , radiology , biliary tract , surgery , pancreatitis , blood pressure
The internal diameter of the common hepatic duct as measured by ultrasonography is an imperfect predictor of extrahepatic biliary obstruction. This study examined the effect of the Valsalva maneuver on the diameter of the duct in 25 consecutive patients (12 with obstruction; 13 without obstruction) who underwent endoscopic retrograde cholangiopancreatography (ERCP). A normal response was defined as a decrease in the diameter of greater than 1 mm at the level of the portal vein. The response to the Valsalva maneuver improved the predictive outcome (sensitivity, 100%; specificity, 92.3%) suggesting that this maneuver should be part of the routine assessment of the common hepatic duct.