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Definition

A percutaneous transhepatic cholangiogram (PTCA) is an x-ray of the bile ducts inside and outside the liver. The x-ray is taken after contrast medium (dye) is injected directly into the bile ducts.

Alternative Names

PTCA; Cholangiogram - PTCA

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 an x-ray machine that projects images onto a TV screen (fluoroscope), 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 removed from the body through the intestines via the bile ducts. It contains bilirubin, which is a product of normal metabolism. If bile cannot be removed from the body, bilirubin collects in the blood and is seen as a yellow discoloration of the skin and eyes (jaundice). One cause of this is a blockage of the bile ducts.

Also, the pancreas creates digestive fluids, which drain via a common bile duct into the intestine. A blockage can prevent the fluids from draining, and may cause pancreatitis (inflammation of the pancreas).

A PTCA test can help identify whether a blockage is causing the jaundice or 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 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

This test has been mostly replaced by an endoscopic retrograde cholangiopancreatography (ERCP) test. A PTCA may be done if an ERCP test cannot be performed or has failed.

A magnetic resonance cholangiopancreatography (MRCP) is a newer, noninvasive imaging method, based on MRI. It provides similar views of the bile ducts, but is not always possible to perform.

ReferencesAlfdahl NH. Diseases of the gall bladder and bile ducts. In: Goldman L, Ausiello D, eds.Cecil Medicine. 23rd ed. Philadelphia, Pa: Saunders Elsevier; 2007:chap 159.
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Related Questions

What is the medical term meaning X-rays examination of the bile ducts?

the answer is POCA Percutaneous Transhepatic Cholangiogram


What are abnormal results of a percutaneous transhepatic cholangiography?

Abnormal results for a percutaneous transhepatic cholangiography are enlargement of bile ducts.


What are normal results of a percutaneous transhepatic cholangiography?

Normal results of a percutaneous transhepatic cholangiography are dye evenly distributed throughout the bile ducts.


How is the patient cared for after the percutaneous transhepatic cholangiography?

Patient aftercare for percutaneous transhepatic cholangiography involve monitoring vital signs and watching for complications. Bed rest for 6 hours.


What does the medical abbreviation PTCA mean?

Percutaneous Transluminal Coronary AngioplastyPercutaneous Transhepatic CholangiographyPercutaneous transluminal Coronary Angioplasty(Balloon)


What conditions may effect the outcome of a percutaneous transhepatic cholangiography?

The conditions of obesity, gas, and failure to fast can affect test results.


What is the medical term meaning examination of the bile duct structure using a needle to pass directly into an intrahepatic bile duct to inject a contrast medium?

The medical term for this procedure is "percutaneous transhepatic cholangiography" (PTC). It involves using a needle to pass through the liver to inject contrast medium into the bile ducts to visualize their structure.


What are the risks of percutaneous transhepatic cholangiography?

The risks of this test are septicemia (blood poisoning); bile peritonitis; dye occasionally leaks from the liver into the abdomen which may cause bleeding or infection.


What is percutaneous transhepatic cholangiography?

an alternative to ERCP that involves the insertion of a long, flexible needle through the skin to the bile ducts; contrast dye is then injected into the ducts so that they may be visualized by x ray.


What are the precautions associated with percutaneous transhepatic cholangiography?

The precautions for having this x-ray test are allergic reactions to anesthetics, dyes used in medical tests, iodine, shellfish; those with cholangitis, massive ascites, bleeding disorders, diabetes.


How is the patient prepared for a percutaneous transhepatic cholangiography?

The patient is prepared by giving an I.V. antibiotic, they must fast overnight, they should stop taking medications (NSAIDs) a week before the procedure and they may be given a sedative just before the test.


What complications of the percutaneous transhepatic cholangiography are looked for after the procedure?

Possible complications after the test are itching, flushing, vomiting, fever, excessive saliva, serious allergic reactions to the dye, pain in the right abdomen/shoulder, dizziness, black or red stool.