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Percutaneous transhepatic cholangiogram (PTCA)Definition A percutaneous transhepatic cholangiogram (PTCA) is a type of x-ray of the bile ducts inside and outside the liver. The x-ray is taken after a contrast medium is injected directly into a liver bile duct. How the test is performed The test is performed in a radiology department by a radiologist. You will be asked to lie on your back on the x-ray table. The upper right side of your abdomen will be cleansed and you will be given a local anesthetic. A long, thin, flexible needle is then inserted through the skin into the liver. With guidance from the fluoroscope (an x-ray machine that projects images onto a TV screen), the bile duct is located and the contrast medium injected. The contrast medium then flows through the ducts and can be seen on the fluoroscopic monitor. How to prepare for the test Inform the health care provider if you are pregnant. You will be given a hospital gown to wear and will be asked to remove all jewelry. How the test will feel There will be a sting as the anesthetic is given and some discomfort as the needle is advanced into the liver. You may be given medication for sedation and/or pain control. Generally, the x-ray itself causes little or no discomfort. Why the test is performed Bile is a by-product of protein metabolism. It is created in the liver and excreted into the intestines via the bile ducts. If bile cannot be removed from the body, it collects in the blood and is seen as a yellow discoloration of the skin and eyes (jaundice). Also, the pancreas creates digestive fluids which drain via a common bile duct into the intestine, and thus obstruction can prevent the drainage of the fluids and may cause pancreatitis (inflammation of the pancreas). A PTCA test can help identify whether a blockage is causing the jaundice and pancreatitis. Normal Values The bile ducts are normal in size and appearance for the age of the patient. What abnormal results mean The results may show that the ducts are enlarged, which may indicate the ducts are blocked. The blockage may be caused by infection, scarring, or stones. It may also indicate cancer in the bile ducts, liver, pancreas, or region of the gallbladder. See also:
What the risks are There is a slight chance of an allergic reaction to the contrast medium (iodine). There is a slight chance of excessive blood loss, blood poisoning (sepsis), and inflammation of the bile ducts. Special considerations An ERCP (endoscopic retrograde cholangiopancreatography) is an invasive procedure performed to visualize the bile ducts and remove any stones. If a diagnostic ERCP cannot be performed, or has failed in the past, a PTCA may be performed. An MRCP (magnetic resonance cholangiopancreatography) is a newer, non-invasive imaging method, based on MRI, which provides similar views of the bile ducts. Illustrations
Page Content: Cholangiogram - PTCA; PTCA ; ptca; guidewires ptca; artery coronary ptca; balloon ptca; angioplasty ptca; high ptca risk |
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