What are the symptoms of bile duct dilatation?

Biliary dilatation is very harmful to patients. Many of the patients are infants and young children. The symptoms of patients are also obvious. The most common symptoms are abdominal lumps and stomach pain. In addition, it often causes jaundice, which is the most common symptom of bile duct dilatation. Abdominal pain is often colic. Patients may experience nausea, vomiting, and even bleeding, which may lead to elevated levels of amylase in urine.

What are the symptoms of bile duct dilatation?

Abdominal mass, abdominal pain, and jaundice are considered the classic triad of symptoms of this disease.

1. Abdominal mass

Located in the right upper abdomen, below the rib margin, a large one may occupy the entire right abdomen. The lump is smooth and spherical, with an obvious cystic elasticity. When the cyst is filled with bile, it may feel solid, like a tumor. However, the size often changes. During infection, pain, and jaundice, the lump will increase in size, and may shrink slightly after the symptoms are relieved. Small bile duct cysts are difficult to palpate due to their deep location.

2. Abdominal pain

It occurs in the middle or right upper abdomen. The nature and degree of pain vary. Sometimes it is persistent bloating and sometimes it is colic. Patients often lie prone with their knees bent and refuse to eat to relieve the symptoms. The onset of abdominal pain indicates obstruction of the bile duct outlet, increased pressure in the common duct, and pancreatic juice and bile can flow back and forth, causing symptoms of cholangitis or pancreatitis. Therefore, it is often accompanied by fever and sometimes nausea and vomiting clinically. Symptoms are often accompanied by increased blood and urine amylase levels.

3. Jaundice

It is mostly intermittent and is often the main symptom in young children. The depth of jaundice is directly related to the degree of biliary obstruction. In mild cases, there may be no jaundice clinically, but with the onset of infection and pain, jaundice may appear temporarily, the stool color may become lighter or grayish white, and the urine color may become darker. The above symptoms are intermittent. Due to the obstruction of the distal bile duct outlet, pancreaticobiliary reflux can cause clinical symptoms. When bile can flow smoothly, the symptoms will be alleviated or disappear. The intervals between attacks vary in length, some attacks are frequent, and some are asymptomatic for a long time.

The typical triad of symptoms was previously thought to be necessary symptoms of this disease, but this is not the case. In early cases, the three major symptoms rarely occur at the same time. Recent reports show that as more and more people are diagnosed early, the number of cases of fusiform dilatation has increased, and the number of patients with triad is less than 10%. In most cases there are only one or two symptoms. According to various reports, abdominal masses can be felt in 60-70% of cases, and jaundice is present in 60-90% of cases. Although jaundice is obviously obstructive, in fact many patients are diagnosed with hepatitis and are not confirmed until after repeated attacks. Abdominal pain also lacks typical manifestations, so it is easy to be misdiagnosed as other abdominal conditions. Multiple intrahepatic and extrahepatic bile duct dilatations usually present symptoms late, until intrahepatic cysts become infected.