Signs of a blocked bile duct
- Yellow eyes and skin
- Dark, tea-coloured urine and pale, clay-coloured stools
- Itching all over
- Pain if a stone is the cause; often painless with a narrowing or growth
Jaundice with fever and shivering can mean infected bile (cholangitis). Go to an emergency department the same day.
Common causes
| Cause | Clue |
|---|---|
| Bile duct stones | Pain, often with gallstones |
| Benign narrowing (stricture) | After surgery, pancreatitis or inflammation |
| Tumour of the pancreas head or bile duct | Painless jaundice, weight loss, itching |
| Chronic pancreatitis | Long history of pancreatic pain |
Finding the cause
Blood tests and ultrasound show whether the duct is widened. CT and MRCP map the ducts, and EUS gives the closest look, with a needle sample if a growth is suspected.
Opening the blockage
Most blockages are relieved by ERCP, by removing stones or placing a plastic or metal stent across a narrowing so bile can drain. If ERCP isn't possible, EUS-guided biliary drainage is an endoscopic alternative to a tube through the skin.
If a tumour may need surgery, the timing and type of stent are planned together with the surgeon.
Common questions
Is all jaundice a liver problem?
No. Hepatitis and other liver diseases cause jaundice too, but a blocked duct is a different problem with a different treatment. Tests sort this out.
How long does a stent last?
Plastic stents are usually changed or removed within about 3 months; metal stents last longer. Your plan depends on the cause.