Bile Duct Stricture
A bile duct stricture is a narrowing of one or more of the ducts that carry bile from the liver and gallbladder to the small intestine. This narrowing can slow or block the flow of bile, leading to jaundice (yellowing of the skin and eyes), itching, dark urine, and pale stools. Strictures can be caused by prior surgery or inflammation, gallstones, chronic diseases of the bile ducts, or, in some cases, tumors. Imaging plays a central role in identifying the site and severity of the narrowing and guiding further treatment.
What is it?
A bile duct stricture occurs when a segment of the bile duct becomes narrowed, limiting the normal flow of bile from the liver and gallbladder into the small intestine. Bile is essential for digesting fats and removing certain waste products from the body. When the duct is narrowed, bile can back up into the liver and bloodstream, causing jaundice, itching, and abnormal liver tests.
Strictures may be benign or malignant. Benign strictures often result from prior surgery, gallstone passage, inflammation, infection, or conditions such as primary sclerosing cholangitis. Malignant strictures can be caused by cancers of the bile ducts (cholangiocarcinoma), pancreas, gallbladder, or surrounding structures. Imaging helps determine the location, length, and appearance of the narrowing, which are important clues to its cause.
Important to Know
Ultrasound, CT, and MRI with MRCP (a special imaging technique for bile ducts) are commonly used to detect bile duct dilatation and identify strictures. In some cases, more direct imaging and treatment are performed with ERCP (endoscopic retrograde cholangiopancreatography), which allows specialists not only to visualize the ducts but also to place stents, dilate narrow areas, or obtain tissue samples. Blood tests and clinical history are combined with imaging to differentiate between benign and malignant causes.
Red flag symptoms include sudden or worsening jaundice, fever with chills, severe right upper abdominal pain, or confusion—these may indicate infection of the bile ducts (cholangitis) or other serious complications and require urgent medical attention. Early evaluation and treatment of bile duct strictures can relieve symptoms, prevent liver damage, and address underlying conditions such as stones, inflammation, or cancer. Follow-up imaging is often recommended to monitor stents or confirm that the duct remains open.