In article <[email hidden]>,
(David Wright) said:In article <[email hidden]>,
Anth said:Sometimes your poo is larger than your anus.
Your anus is designed to stretch briefly to accomodate this
situation. Your common bile duct is not. It will stretch a
tiny bit, but I gather the pain is excruciating. A marble-
sized object is *not* going to go through, period.
The normal diameter of the common bile duct (CBD) is less than 10 mm. In
cases of chronic common bile duct obstruction, it can gradually stretch
without much pain to around 20-25 mm, but this nearly always accompanied
by jaundice and is nearly always caused by malignancy. Acute CBD
obstruction, as caused by gallstones, is nearly always accompanied by
severe right upper quadrant or epigastric pain.
Also, even if a small gallstone of, say 10 mm in diameter, did manage to
find its way into the CBD, in most cases, it would very likely lodge at
and obstruct the Sphincter of Oddi (a sphicter found where the CBD
enters the duodenum). Indeed, endoscopists often cut this sphincter
during endoscopic retrograde cholangiopancreatography (ERCP) to allow
gallstones in the biliary tree to pass or to be extracted with various
endoscopic instruments. If lots of gallstones find their way into the
CBD, complications can include jaundice, ascending cholangitis (a
life-threatening infection of the biliary tree), or gallstone
pancreatitis (another potentially life-threatening condition).
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