Medical Surgical Nursing

D. Obstruction of bile flow: also interferes with absorption of the fat-soluble

vitamins. The patient may exhibit deficiencies (eg, bleeding caused by vitamin

K deficiency) of these vitamins if biliaryobstruction has been prolonged.

Assessment and Diagnostic Findings

 Abdominal X-ray

o Ultrasonography

o Cholecystography

o Endoscopic retrograde cholangiopancreatography(ERCP)

o Percutaneoustranshepaticcholangiography

o Endoscopic retrograde cholangiopancreatography(ERCP). A

fiberopticduodenoscope, with side-viewing apparatus, is inserted into

the duodenum. The ampullaof Vateris catheterized and the biliarytree

injected with contrast agent. The pancreatic ductalsystem is also

assessed, if indicated.

This procedure is of special value in visualizing neoplasmsof the

ampullaarea and extracting a biopsy specimen.