Signature: © Pol J Radiol, 2010; 75(3): 20-24 O R I G I N A L A R T I C L E Received: 2010.04.23 Accepted: 2010.06.08 Common Bile Duct (CBD) diameter in opium-addicted men: Comparison with non-addict controls Background: Material/Methods: Results: Conclusions: Nina Zahedi-Nejad, Shahin Narouei, Farnaz Fahimy Kerman University of Medical Sciences, Kerman, Iran Author’s address: Nina Zahedi-Nejad, Kerman University of Medical Sciences, Kerman, Iran, e-mail: ninagol26@yahoo.com Summary Opium and its derivatives are widely abused throughout the world. Recent case reports and a few limited studies have suggested that opiates cause dilation of the common bile duct of the abusers. Our case-control study, lasting 7.5 months, investigated 121 male adult addicts and 142 non- addicted controls for biliary tract diameters, using ultrasonography. The study was conducted in Bahonar Hospital in Kerman. Neither the addiction cases nor the non-addict controls revealed any hepatobiliary tract symptoms. The subjects were asked to fill in a questionnaire. After the exclusion of the symptomatic cases, ultrasound examinations were carried out and the findings from questionnaires and US examinations were recorded. The mean ±SD diameter of the common bile duct was 4.78±2.58 for addicts and 3.37±2.25 for non-addicts. CBD wall thickness was 1.969±0.61 mm in addicts versus 1.73±0.631 in non-addicts. The differences were statistically significant. According to the multivariate analysis, the duration of opium abuse was a significant factor. We concluded that CBD dilation and increased CBD wall thickness can be expected in people with a prolonged history of opiate addiction. Key words: opium • addiction • CBD • common bile duct • Kerman • Iran PDF file: http://www.polradiol.com/fulltxt.php?ICID=881144 Background Opium, being a juice extracted from opium poppy and solidifying into a brownish material originally used for medical purposes, reveals strong habit-forming properties and is abused by many people in most countries, including Iran. Addiction is considered to be a mental disorder which requires medical intervention [1] but it should be remem- bered that it affects all aspects of the victim’s life. Opiate dependence results in many social problems of the victim, his family and community. Furthermore, it carries many health hazards for the abusers, which has been discussed for many years now [2]. Opiates affect the physiological function of the Oddi’s sphincter which delays gallbladder emptying [3–6]. Scattered case reports mention the possibility of either common bile duct (CBD) dilation [7–10] or constriction [11]. 20 A recent publication from Singapore reported a more dilat- ed CBD in seven addicts with GI symptoms than in seven non-addicts [7]. Next, there was a report by Rafsanjan from Iran, evaluating a group of 100 opiate addicts and sup- porting the aforementioned observations [12]. However, the report did not have a control group to compare with. Furthermore, the reason for such a dilation is not clear. Should it be just a mechanical effect of the Oddi’s sphincter dysfunction? Is it possible that some inflammatory changes in the hepatobiliary system are involved? CBD wall thick- ness can provide indirect information regarding the second question. The purpose of this study was to measure and to compare the common bile duct diameter and CBD wall thickness in a group of opium addicts and in an age-matched non- addict control group composed of people living in Kerman, Iran.