BACK TOTOP Browse A-ZSearchBrowse A-ZABCDEFGHIJKLMNOPQRSTUVWXYZ0-9 E-mail FormEmail ResultsName:Email address:Recipients Name:Recipients address:Message: Print-FriendlyBookmarksbookmarks-menuBile duct obstructionBiliary obstructionBile duct obstruction is a blockage in the tubes that carry bile from the liver to the gallbladder and small intestine. Causes Bile is a liquid released by the liver. It contains cholesterol, bile salts, and waste products such as bilirubin. Bile salts help your body break down (digest) fats. Bile passes out of the liver through the bile ducts and is stored in the gallbladder. After a meal, it is released into the small intestine.BileBile is a fluid that is made and released by the liver and stored in the gallbladder. Bile helps with digestion. It breaks down fats into fatty acid...ImageRead Article Now Book Mark Article BilirubinThe bilirubin blood test measures the level of bilirubin in the blood. Bilirubin is a yellowish pigment found in bile, a fluid made by the liver. Bi...ImageRead Article Now Book Mark Article When the bile ducts become blocked, bile builds up in the liver, and jaundice (yellow color of the skin) develops due to the increasing level of bilirubin in the blood.The possible causes of a blocked bile duct include:Cysts of the common bile duct Enlarged lymph nodes in the porta hepatis Gallstones GallstonesGallstones are hard deposits that form inside the gallbladder. These may be as small as a grain of sand or as large as a golf ball.ImageRead Article Now Book Mark Article Inflammation of the bile ducts Narrowing of the bile ducts from scarring Injury from gallbladder surgery Tumors of the bile ducts or pancreas Tumors that have spread to the biliary system Biliary systemThe biliary system creates, moves, stores, and releases bile into the duodenum. This helps the body digest food. It also assists in transporting wa...ImageRead Article Now Book Mark Article Liver and bile duct worms (flukes)The risk factors for a blocked bile duct include:History of gallstones, chronic pancreatitis, or pancreatic cancer Chronic pancreatitisPancreatitis is swelling of the pancreas. Chronic pancreatitis is present when this problem does not heal or recurs and does not improve, gets worse...ImageRead Article Now Book Mark Article Pancreatic cancerPancreatic cancer is cancer that starts in the pancreas.ImageRead Article Now Book Mark Article Injury to the abdominal area Recent biliary surgery Biliary surgeryOpen gallbladder removal is surgery to remove the gallbladder through a large cut in your abdomen. The gallbladder is an organ that sits below the li...ImageRead Article Now Book Mark Article Recent biliary cancer (such as bile duct cancer) Bile duct cancerCholangiocarcinoma (CCA) is a rare cancerous (malignant) growth in one of the ducts that carries bile from the liver to the small intestine.ImageRead Article Now Book Mark Article The blockage can also be caused by infections. This is more common in people with weakened immune systems. Symptoms Symptoms may include:Abdominal pain in the upper right side Abdominal painAbdominal pain is pain that you feel anywhere between your chest and groin. This is often referred to as the stomach region or belly.ImageRead Article Now Book Mark Article Dark urine Dark urineBlood in your urine is called hematuria. The amount may be very small and only detected with urine tests or under a microscope. In other cases, the...ImageRead Article Now Book Mark Article Fever FeverFever is the temporary increase in the body's temperature in response to a disease or illness. A child has a fever when the temperature is at or abov...ImageRead Article Now Book Mark Article Itching ItchingItching is a tingling or irritation of the skin that makes you want to scratch the area. Itching may occur all over the body or only in one location...ImageRead Article Now Book Mark Article Jaundice (yellow skin color) Nausea and vomiting Clay-colored or pale stoolsClay-colored or pale stoolsStools that are pale, clay, or putty-colored may be due to problems in the biliary system. The biliary system is the drainage system of the gallblad...ImageRead Article Now Book Mark Article Exams and Tests Your health care provider will examine you and feel your belly. The following blood test results could be due to a possible blockage:Increased bilirubin level Increased alkaline phosphatase level Increased GGT enzyme level Increased liver enzymes The following tests may be used to investigate a possible blocked bile duct:Abdominal ultrasound Abdominal ultrasoundAbdominal ultrasound is a type of imaging test. It is used to look at organs in the abdomen, including the liver, gallbladder, spleen, pancreas, and...ImageRead Article Now Book Mark Article Abdominal CT scan Abdominal CT scanAn abdominal CT scan is an imaging method. This test uses x-rays to create cross-sectional pictures of the belly area. CT stands for computed tomog...ImageRead Article Now Book Mark Article Endoscopic retrograde cholangiopancreatography (ERCP) Percutaneous transhepatic cholangiogram (PTCA) Percutaneous transhepatic cholangiogramA percutaneous transhepatic cholangiogram (PTC) is an x-ray of the bile ducts. These are the tubes that carry bile from the liver to the gallbladder...ImageRead Article Now Book Mark Article Magnetic resonance cholangiopancreatography (MRCP) Endoscopic ultrasound (EUS) A blocked bile duct may also alter the results of the following tests: Amylase blood test Gallbladder radionuclide scan Gallbladder radionuclide scanGallbladder radionuclide scan is a test that uses radioactive material to check gallbladder function. It is also used to look for bile duct blockage...ImageRead Article Now Book Mark Article Lipase blood test Prothrombin time (PT) Urine bilirubinUrine bilirubinBilirubin is a yellowish pigment found in bile, which is a fluid produced by the liver and stored in the gallbladder. This article is about a lab tes...ImageRead Article Now Book Mark Article Treatment The goal of treatment is to relieve the blockage. Stones may be removed using an endoscope during an ERCP.In some cases, surgery is required to bypass the blockage. The gallbladder will usually be surgically removed if the blockage is caused by gallstones. Your provider may prescribe antibiotics if an infection is suspected.If the blockage is caused by cancer, the duct may need to be widened. This procedure is called endoscopic or percutaneous (through the skin next to the liver) dilation. A tube may need to be placed to allow drainage. Outlook (Prognosis) If the blockage is not corrected, it can lead to life-threatening infection and a dangerous buildup of bilirubin.If the blockage lasts a long time, chronic liver disease can result. Most obstructions can be treated with endoscopy or surgery. Obstructions caused by cancer often have a worse outcome.Liver diseaseThe term "liver disease" applies to many conditions that stop the liver from working or prevent it from functioning well. Abdominal pain or swelling...ImageRead Article Now Book Mark Article Possible Complications Left untreated, the possible complications include infections, sepsis, and liver disease, such as biliary cirrhosis.SepsisSepsis is an illness in which the body has a severe, inflammatory response to bacteria or other germs.ImageRead Article Now Book Mark Article CirrhosisCirrhosis is scarring of the liver and poor liver function. It is the last stage of chronic liver disease.ImageRead Article Now Book Mark Article When to Contact a Medical Professional Contact your provider if you:Notice a change in the color of your urine and stools Develop jaundice Have abdominal pain that doesn't go away or keeps recurring Prevention Be aware of any risk factors you have, so that you can get prompt diagnosis and treatment if a bile duct becomes blocked. The blockage itself may not be preventable.Open ReferencesReferencesFogel EL, Sherman S. Diseases of the gallbladder and bile ducts. In: Goldman L, Schafer AI, eds. Goldman-Cecil Medicine. 26th ed. Philadelphia, PA: Elsevier; 2020:chap 146.Lidofsky SD. Jaundice. In: Feldman M, Friedman LS, Brandt LJ, eds. Sleisenger and Fordtran's Gastrointestinal and Liver Disease. 11th ed. Philadelphia, PA: Elsevier; 2021:chap 21.AllVideoImagesTogDigestive system - illustration The esophagus, stomach, large and small intestine, aided by the liver, gallbladder and pancreas convert the nutritive components of food into energy and break down the non-nutritive components into waste to be excreted.Digestive systemillustrationEndocrine glands - illustration Endocrine glands release hormones (chemical messengers) into the bloodstream to be transported to various organs and tissues throughout the body. For instance, the pancreas secretes insulin, which allows the body to regulate levels of sugar in the blood. The thyroid gets instructions from the pituitary to secrete hormones which determine the rate of metabolism in the body (the more hormone in the bloodstream, the faster the chemical activity; the less hormone, the slower the activity).Endocrine glandsillustrationBile pathway - illustration The biliary system is comprised of the organs and duct system that create, transport, store and release bile into the duodenum for digestion. Includes the liver, gallbladder and bile ducts (named the cystic, hepatic, common, and pancreatic duct).Bile pathwayillustrationBiliary obstruction - series - Normal anatomyPresentation Digestive system - illustration The esophagus, stomach, large and small intestine, aided by the liver, gallbladder and pancreas convert the nutritive components of food into energy and break down the non-nutritive components into waste to be excreted.Digestive systemillustrationEndocrine glands - illustration Endocrine glands release hormones (chemical messengers) into the bloodstream to be transported to various organs and tissues throughout the body. For instance, the pancreas secretes insulin, which allows the body to regulate levels of sugar in the blood. The thyroid gets instructions from the pituitary to secrete hormones which determine the rate of metabolism in the body (the more hormone in the bloodstream, the faster the chemical activity; the less hormone, the slower the activity).Endocrine glandsillustrationBile pathway - illustration The biliary system is comprised of the organs and duct system that create, transport, store and release bile into the duodenum for digestion. Includes the liver, gallbladder and bile ducts (named the cystic, hepatic, common, and pancreatic duct).Bile pathwayillustration Biliary obstruction - series - Normal anatomyPresentation A Closer Look Gallstones and gallbladder disease - InDepth(In-Depth) Tests for Bile duct obstruction Gallbladder radionuclide scanRelated Information Bile(Special Topic)Bilirubin blood test(Medical Test)Gallstones(Condition)Biliary system(Special Topic)Chronic pancreatitis(Condition)Pancreatic cancer(Condition)Open gallbladder removal(Surgery)Cholangiocarcinoma(Condition)Sepsis(Condition)Cirrhosis(Condition)Cholesterol - InDepth(In-Depth)Hepatitis - InDepth(In-Depth)Gallstones and gallbladder disease - InDepth(In-Depth) Review Date: 5/4/2022 Reviewed By: Michael M. Phillips, MD, Emeritus Professor of Medicine, The George Washington University School of Medicine, Washington, DC. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team. The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed medical professional should be consulted for diagnosis and treatment of any and all medical conditions. Links to other sites are provided for information only -- they do not constitute endorsements of those other sites. No warranty of any kind, either expressed or implied, is made as to the accuracy, reliability, timeliness, or correctness of any translations made by a third-party service of the information provided herein into any other language. © 1997- A.D.A.M., a business unit of Ebix, Inc. Any duplication or distribution of the information contained herein is strictly prohibited. © 1997- All rights reserved. A.D.A.M. content is best viewed in IE9 or above, Firefox and Google Chrome browser.Content is best viewed in IE9 or above, Firefox and Google Chrome browser.
Bile duct obstructionBiliary obstructionBile duct obstruction is a blockage in the tubes that carry bile from the liver to the gallbladder and small intestine. Causes Bile is a liquid released by the liver. It contains cholesterol, bile salts, and waste products such as bilirubin. Bile salts help your body break down (digest) fats. Bile passes out of the liver through the bile ducts and is stored in the gallbladder. After a meal, it is released into the small intestine.BileBile is a fluid that is made and released by the liver and stored in the gallbladder. Bile helps with digestion. It breaks down fats into fatty acid...ImageRead Article Now Book Mark Article BilirubinThe bilirubin blood test measures the level of bilirubin in the blood. Bilirubin is a yellowish pigment found in bile, a fluid made by the liver. Bi...ImageRead Article Now Book Mark Article When the bile ducts become blocked, bile builds up in the liver, and jaundice (yellow color of the skin) develops due to the increasing level of bilirubin in the blood.The possible causes of a blocked bile duct include:Cysts of the common bile duct Enlarged lymph nodes in the porta hepatis Gallstones GallstonesGallstones are hard deposits that form inside the gallbladder. These may be as small as a grain of sand or as large as a golf ball.ImageRead Article Now Book Mark Article Inflammation of the bile ducts Narrowing of the bile ducts from scarring Injury from gallbladder surgery Tumors of the bile ducts or pancreas Tumors that have spread to the biliary system Biliary systemThe biliary system creates, moves, stores, and releases bile into the duodenum. This helps the body digest food. It also assists in transporting wa...ImageRead Article Now Book Mark Article Liver and bile duct worms (flukes)The risk factors for a blocked bile duct include:History of gallstones, chronic pancreatitis, or pancreatic cancer Chronic pancreatitisPancreatitis is swelling of the pancreas. Chronic pancreatitis is present when this problem does not heal or recurs and does not improve, gets worse...ImageRead Article Now Book Mark Article Pancreatic cancerPancreatic cancer is cancer that starts in the pancreas.ImageRead Article Now Book Mark Article Injury to the abdominal area Recent biliary surgery Biliary surgeryOpen gallbladder removal is surgery to remove the gallbladder through a large cut in your abdomen. The gallbladder is an organ that sits below the li...ImageRead Article Now Book Mark Article Recent biliary cancer (such as bile duct cancer) Bile duct cancerCholangiocarcinoma (CCA) is a rare cancerous (malignant) growth in one of the ducts that carries bile from the liver to the small intestine.ImageRead Article Now Book Mark Article The blockage can also be caused by infections. This is more common in people with weakened immune systems. Symptoms Symptoms may include:Abdominal pain in the upper right side Abdominal painAbdominal pain is pain that you feel anywhere between your chest and groin. This is often referred to as the stomach region or belly.ImageRead Article Now Book Mark Article Dark urine Dark urineBlood in your urine is called hematuria. The amount may be very small and only detected with urine tests or under a microscope. In other cases, the...ImageRead Article Now Book Mark Article Fever FeverFever is the temporary increase in the body's temperature in response to a disease or illness. A child has a fever when the temperature is at or abov...ImageRead Article Now Book Mark Article Itching ItchingItching is a tingling or irritation of the skin that makes you want to scratch the area. Itching may occur all over the body or only in one location...ImageRead Article Now Book Mark Article Jaundice (yellow skin color) Nausea and vomiting Clay-colored or pale stoolsClay-colored or pale stoolsStools that are pale, clay, or putty-colored may be due to problems in the biliary system. The biliary system is the drainage system of the gallblad...ImageRead Article Now Book Mark Article Exams and Tests Your health care provider will examine you and feel your belly. The following blood test results could be due to a possible blockage:Increased bilirubin level Increased alkaline phosphatase level Increased GGT enzyme level Increased liver enzymes The following tests may be used to investigate a possible blocked bile duct:Abdominal ultrasound Abdominal ultrasoundAbdominal ultrasound is a type of imaging test. It is used to look at organs in the abdomen, including the liver, gallbladder, spleen, pancreas, and...ImageRead Article Now Book Mark Article Abdominal CT scan Abdominal CT scanAn abdominal CT scan is an imaging method. This test uses x-rays to create cross-sectional pictures of the belly area. CT stands for computed tomog...ImageRead Article Now Book Mark Article Endoscopic retrograde cholangiopancreatography (ERCP) Percutaneous transhepatic cholangiogram (PTCA) Percutaneous transhepatic cholangiogramA percutaneous transhepatic cholangiogram (PTC) is an x-ray of the bile ducts. These are the tubes that carry bile from the liver to the gallbladder...ImageRead Article Now Book Mark Article Magnetic resonance cholangiopancreatography (MRCP) Endoscopic ultrasound (EUS) A blocked bile duct may also alter the results of the following tests: Amylase blood test Gallbladder radionuclide scan Gallbladder radionuclide scanGallbladder radionuclide scan is a test that uses radioactive material to check gallbladder function. It is also used to look for bile duct blockage...ImageRead Article Now Book Mark Article Lipase blood test Prothrombin time (PT) Urine bilirubinUrine bilirubinBilirubin is a yellowish pigment found in bile, which is a fluid produced by the liver and stored in the gallbladder. This article is about a lab tes...ImageRead Article Now Book Mark Article Treatment The goal of treatment is to relieve the blockage. Stones may be removed using an endoscope during an ERCP.In some cases, surgery is required to bypass the blockage. The gallbladder will usually be surgically removed if the blockage is caused by gallstones. Your provider may prescribe antibiotics if an infection is suspected.If the blockage is caused by cancer, the duct may need to be widened. This procedure is called endoscopic or percutaneous (through the skin next to the liver) dilation. A tube may need to be placed to allow drainage. Outlook (Prognosis) If the blockage is not corrected, it can lead to life-threatening infection and a dangerous buildup of bilirubin.If the blockage lasts a long time, chronic liver disease can result. Most obstructions can be treated with endoscopy or surgery. Obstructions caused by cancer often have a worse outcome.Liver diseaseThe term "liver disease" applies to many conditions that stop the liver from working or prevent it from functioning well. Abdominal pain or swelling...ImageRead Article Now Book Mark Article Possible Complications Left untreated, the possible complications include infections, sepsis, and liver disease, such as biliary cirrhosis.SepsisSepsis is an illness in which the body has a severe, inflammatory response to bacteria or other germs.ImageRead Article Now Book Mark Article CirrhosisCirrhosis is scarring of the liver and poor liver function. It is the last stage of chronic liver disease.ImageRead Article Now Book Mark Article When to Contact a Medical Professional Contact your provider if you:Notice a change in the color of your urine and stools Develop jaundice Have abdominal pain that doesn't go away or keeps recurring Prevention Be aware of any risk factors you have, so that you can get prompt diagnosis and treatment if a bile duct becomes blocked. The blockage itself may not be preventable.Open ReferencesReferencesFogel EL, Sherman S. Diseases of the gallbladder and bile ducts. In: Goldman L, Schafer AI, eds. Goldman-Cecil Medicine. 26th ed. Philadelphia, PA: Elsevier; 2020:chap 146.Lidofsky SD. Jaundice. In: Feldman M, Friedman LS, Brandt LJ, eds. Sleisenger and Fordtran's Gastrointestinal and Liver Disease. 11th ed. Philadelphia, PA: Elsevier; 2021:chap 21.