Bile duct obstruction
Biliary 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.
Bile
Bile 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...
Read Article Now Book Mark ArticleBilirubin
The 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...
Read Article Now Book Mark ArticleWhen 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 (an area on the underside of the liver through which the bile duct passes)
- Gallstones
Gallstones
Gallstones 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.
Read Article Now Book Mark Article - Inflammation of the bile ducts
- Narrowing of the bile ducts from scarring
- Injury of a bile duct from gallbladder surgery
- Tumors of the bile ducts or pancreas
- Tumors that have spread to the biliary system
Biliary system
The biliary system creates, moves, stores, and releases bile into the duodenum. This helps the body digest food. It also assists in transporting wa...
Read Article Now Book Mark Article - Liver and bile duct worms (flukes)
The risk factors for a blocked bile duct include:
- A history of gallstones, chronic pancreatitis, or pancreatic cancer
Chronic pancreatitis
Pancreatitis is swelling of the pancreas. Chronic pancreatitis is present when this problem does not heal or recurs and does not improve, gets worse...
Read Article Now Book Mark ArticlePancreatic cancer
Pancreatic cancer is cancer that starts in the pancreas.
Read Article Now Book Mark Article - Injury to the abdominal area
- Recent biliary surgery
Biliary surgery
Open 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...
Read Article Now Book Mark Article - Recent biliary cancer (such as bile duct cancer)
Bile duct cancer
Cholangiocarcinoma (CCA) is a rare cancerous (malignant) growth in one of the ducts that carries bile from the liver to the small intestine.
Read 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 pain
Abdominal pain is pain that you feel anywhere between your chest and groin. This is often referred to as the stomach region or belly.
Read Article Now Book Mark Article - Dark urine
Dark urine
Blood 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...
Read Article Now Book Mark Article - Fever
Fever
Fever 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...
Read Article Now Book Mark Article - Itching
Itching
Itching 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...
Read Article Now Book Mark Article - Jaundice (yellow skin color)
- Nausea and vomiting
- Clay-colored or pale stools
Clay-colored or pale stools
Stools 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...
Read 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 bile duct 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 ultrasound
Abdominal ultrasound is a type of imaging test. It is used to look at organs in the abdomen, including the liver, gallbladder, spleen, pancreas, and...
Read Article Now Book Mark Article - Abdominal CT scan
Abdominal CT scan
An 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...
Read Article Now Book Mark Article - Endoscopic retrograde cholangiopancreatography (ERCP)
- Percutaneous transhepatic cholangiogram (PTCA)
Percutaneous transhepatic cholangiogram
A 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...
Read 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 scan
Gallbladder radionuclide scan is a test that uses radioactive material to check gallbladder function. It is also used to look for bile duct blockage...
Read Article Now Book Mark Article - Lipase blood test
- Prothrombin time (PT)
- Urine bilirubin
Urine bilirubin
Bilirubin 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...
Read 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 (stent or drain) 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 disease
The term "liver disease" applies to many conditions that stop the liver from working or prevent it from functioning well. Abdominal pain or swelling...
Read Article Now Book Mark ArticlePossible Complications
Left untreated, the possible complications include infections, sepsis, and liver disease, such as biliary cirrhosis.
Sepsis
Sepsis is an illness in which the body has a severe, inflammatory response to bacteria or other germs.
Read Article Now Book Mark ArticleCirrhosis
Cirrhosis is scarring of the liver and poor liver function. It is the last stage of chronic liver disease.
Read Article Now Book Mark ArticleWhen 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.
References
Fogel EL, Sherman S. Diseases of the gallbladder and bile ducts. In: Goldman L, Cooney KA, eds. Goldman-Cecil Medicine. 27th ed. Philadelphia, PA: Elsevier; 2024:chap 141.
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.
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 system
illustration
Endocrine 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 glands
illustration
Bile 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 pathway
illustration
Biliary obstruction - series - Normal anatomy
Presentation
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 system
illustration
Endocrine 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 glands
illustration
Bile 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 pathway
illustration
Biliary obstruction - series - Normal anatomy
Presentation
Review Date: 6/11/2024
Reviewed By: Jenifer K. Lehrer, MD, Department of Gastroenterology, Aria - Jefferson Health Torresdale, Jefferson Digestive Diseases Network, Philadelphia, PA. Review provided by VeriMed Healthcare Network. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.