The significance of gas or barium in the biliary tract

1. A series of ten cases in which gas or barium was shown in the biliary tract is reported. None of these was due to gas forming infections. These cases were all seen in a period of three years. Six of them were due to regurgitation through the sphincter of Oddi, two were due to a biliary fistula and two were associated with operative anastomosis to the gall bladder. Six of the patients had had jaundice. 2. The importance of looking for and recognising the presence of gas in the biliary tract is stressed. A positive finding provides evidence of incontinence of the sphincter of Oddi or biliary fistula. Incontinence of the sphincter is thought to be most often due to the passage of stones through it though other causes may be responsible. 3. The presence of gas in the biliary system together with evidence of intestinal obstruction makes gall stone impaction a probable diagnosis. 4. Patency of the sphincter of Oddi may be either temporary or persistent. In one case reported patency was present for four-and-a...