Differential Diagnosis for Intrahepatic and Extrahepatic Biliary Duct Dilation with Common Bile Duct Dilation

• Single Most Likely Diagnosis
  • Choledocholithiasis: This condition, where gallstones obstruct the common bile duct, is a common cause of biliary duct dilation. The obstruction leads to the accumulation of bile, causing the ducts to dilate.
• Other Likely Diagnoses
  • Cholangiocarcinoma: A malignancy of the bile duct that can cause obstruction, leading to dilation of the biliary ducts.
  • Pancreatic cancer: Tumors in the head of the pancreas can obstruct the common bile duct, causing dilation.
  • Biliary stricture: Narrowing of the bile ducts due to scarring or inflammation, which can obstruct bile flow and cause dilation.
  • Parasitic infections (e.g., ascaris, hydatid disease): Certain parasites can obstruct the biliary ducts, leading to dilation.
• Do Not Miss Diagnoses
  • Ampullary cancer: A rare tumor at the junction of the bile and pancreatic ducts that can cause obstruction and dilation.
  • Mirizzi syndrome: A condition where a gallstone becomes impacted in the cystic duct, causing obstruction of the common bile duct and potentially leading to dilation.
  • Primary sclerosing cholangitis (PSC): A chronic liver disease characterized by inflammation and scarring of the bile ducts, which can lead to dilation and obstruction.
• Rare Diagnoses
  • Caroli's disease: A rare congenital disorder characterized by non-obstructive dilatation of the intrahepatic bile ducts.
  • Choledochal cysts: Congenital anomalies of the bile duct that can cause dilation and obstruction.
  • Biliary atresia: A rare disease of the bile ducts that affects infants, leading to obstruction and dilation.
  • HIV cholangiopathy: A condition associated with HIV infection that can cause dilation and obstruction of the biliary ducts.