We're unable to sign you in at this time. Please try again in a few minutes.
We were able to sign you in, but your subscription(s) could not be found. Please try again in a few minutes.
There may be a problem with your account. Please contact the AMA Service Center to resolve this issue.
Contact the AMA Service Center:
Telephone: 1 (800) 262-2350 or 1 (312) 670-7827  *   Email: subscriptions@jamanetwork.com
Error Message ......
Article |

Pseudo-obstruction of the Common Duct in Operative Cholangiography

Arch Surg. 1975;110(1):17. doi:10.1001/archsurg.1975.01360070017001.
Text Size: A A A
Published online


Nonpassage of contrast media into the duodenum may be caused by spasm of the sphincter of Boyden and is a well-recognized diagnostic problem in operative cholangiography. Chessick et al (see pp 53-57) have alerted the surgeon to the possible etiologic role of fentanyl. If fentanyl is found to directly induce or potentiate spasm in a majority of patients, an alternative anesthetic may be advised during biliary surgery.

As Chessick et al also point out, however, there are many variables in operative cholangiography and a number of these might induce spasm. In 56 postcholedochotomy cholangiograms reported by Ginzburg et al,1 no duodenal drainage was seen in 24 (43%), but subsequent postoperative T-tube cholangiography was normal for all of these patients. No mention was made of the anesthetic used. Baker2 has noted a 25% incidence of pseudo-obstruction after common duct instrumentation. Such high incidences of apparent obstruction due to spasm


Sign in

Purchase Options

• Buy this article
• Subscribe to the journal
• Rent this article ?

First Page Preview

View Large
First page PDF preview





Also Meets CME requirements for:
Browse CME for all U.S. States
Accreditation Information
The American Medical Association is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. The AMA designates this journal-based CME activity for a maximum of 1 AMA PRA Category 1 CreditTM per course. Physicians should claim only the credit commensurate with the extent of their participation in the activity. Physicians who complete the CME course and score at least 80% correct on the quiz are eligible for AMA PRA Category 1 CreditTM.
Note: You must get at least of the answers correct to pass this quiz.
Please click the checkbox indicating that you have read the full article in order to submit your answers.
Your answers have been saved for later.
You have not filled in all the answers to complete this quiz
The following questions were not answered:
Sorry, you have unsuccessfully completed this CME quiz with a score of
The following questions were not answered correctly:
Commitment to Change (optional):
Indicate what change(s) you will implement in your practice, if any, based on this CME course.
Your quiz results:
The filled radio buttons indicate your responses. The preferred responses are highlighted
For CME Course: A Proposed Model for Initial Assessment and Management of Acute Heart Failure Syndromes
Indicate what changes(s) you will implement in your practice, if any, based on this CME course.


Some tools below are only available to our subscribers or users with an online account.

0 Citations

Sign in

Purchase Options

• Buy this article
• Subscribe to the journal
• Rent this article ?

Related Content

Customize your page view by dragging & repositioning the boxes below.