الفهرس 
INTRODUCTIONOnly 14 pages are availabe for public view
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Abstract
ilated common bile duct (CBD) is commonly seen in clinical practice and usually represents an obstructive lesion limiting the flow of bile. The most common causes of dilated common bile duct are choledocholithiasis, passed common bile duct stone, post cholecystectomy state, ampullary neoplasia, cholangiocarcinoma and pancreatic head cancer. (Surinder Singh et al., 2013).
Generally, patients who present with cholestasis are evaluated with US or CT. However, these investigations are frequently inconclusive, and additional evaluation is required to establish the diagnosis. Over the last decade, several studies have demonstrated that EUS is effective in this setting.
EUS compines endoscopy and US to provide remarkably detailed images of the pancrease and biliary tree.It uses higher frequency ultrasonic waves compared to traditional us and allow diagnostic tissue sampling via EUS guided fine needle aspiration (EUS FNA).
The aim of this study is to assess the value of EUS in identifying the cause of CBD dilatation undiagnosed by transabdominal ultrasongraphy, CT or MRI.
The study was done at The Gastroenterology and Hepatology Department, Kobry Elkobba Military hospital between octobor 2017and August 2018.
Written consents were taken from all patients in this study.
The study included 50 patients with common bile duct dilatation of undetermined origin on abdominal ultrasonography, CT and MRI or those with dilated biliary system, suspected periampullary lesions and enlarged pancreatic head with no definite focal masses who were sent for more clarification by EUS.
In this study comparison between diagnostic characteristics of US, CT, and EUS in prediction of malignancy showed that US had low sensitivity (57.1%) and high specificity (100%), CT had low sensitivity (68.6%) and high specificity (100%) while EUS had moderate sensitivity (85.7%) and high specificity (100%).