Tumors of distal bile-excreting ducts and
major duodenal papilla due to tumorous invasion, circular squeezing and growth
into a lumen of a duct may cause an obstruction. At the same time indirect
symptoms of biliary obstruction are registered: dilation of proximal areas of
bile ducts; enlargement of gall bladder; development of hepatic changes, typical
for hepatic secretory obstruction. At accompanying obstruction of main
pancreatic duct directly at the point of transition to ampoule, a dilation of a
duct is detected distal to obstruction level.
In the second group of 20 patients with major
duodenal papilla tumor in 6 patients we registered a growth of a tumor into a
lumen of a duodenum, in 14 patients – into a lumen of a common bile duct.
Precise diagnostics with ultrasound research was done in 19 patients (in 1
patient with growth of a tumor into a lumen of a common bile duct ultrasound
found a tumor of pancreatic head with metastases into distal parts of a common
bile duct).
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