Diagnostic Ultrasound - Abdomen and Pelvis

Biliary System
COMMON BILE DUCT
Anatomy: Abdomen
Common bile duct
Hepatic artery
Main portal vein
Inferior vena cava
Head of pancreas
Common bile duct
Body of pancreas
Splenic vein
Superior mesenteric artery
Left renal vein
Aorta
Vertebral body
(Top) Subcostal, longitudinal oblique ultrasound shows the common bile duct and the portal vein in the hepatoduodenal ligament. The
common bile duct is normally identified anterior to the portal vein. The distal common bile duct pierces the pancreatic head. Also
demonstrated is the hepatic artery, which normally traverses between the portal vein and common bile duct. (Bottom) Transverse
ultrasound at the level of the pancreas demonstrates the distal common bile duct as it pierces the pancreatic head. Overlying bowel gas
may obscure this area; positioning the patient upright or in a left lateral decubitus position may help visualization.
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