The bile ducts are passages that transport bile from the gall bladder. X-ray examination of these ducts is sometimes done by PTHC. PTHC stands for percutaneous transhepatic cholangiography. During PTHC, examiners inject a contrast dye into the liver. The test tells them if slowed or stopped bile flow is due to a blockage. If not, it is likely due to liver disease. The procedure poses a slight risk of bleeding, infection, and misplaced contrast dye.

PTHC is used to:
* find cause of pain after gall bladder removal,
* tell if jaundice is caused by an obstruction, and
* find the site of obstruction.

The person must fast for 8 hours before the test. It requires at least 6 hours bed rest afterward. The person lies on an X-ray table that tilts at various angles while the examiner injects a local anesthetic into the liver. A mild sedative may be given. A flexible needle delivers a dye deep in the liver. The examiner watches the dye flow through bile ducts on a fluoroscope. A fluoroscope uses constant X-rays to produce a moving image. Still X-rays also record findings. The test lasts for about 30 minutes.

Enlarged ducts may indicate a blockage. If ducts are normal size, the healthcare provider may recommend a liver biopsy. A biopsy of the liver is used to diagnose:
* hepatitis,
* cirrhosis, and
* other liver disease.

People who are extremely sensitive to iodine or have severe bleeding disorders should not have PTHC. Past reactions to shellfish may indicate iodine sensitivity. Possible side effects of the contrast dye include nausea, vomiting, flushing, itching, sweating, and salivating. On rare occasions a person may have an extreme allergic reaction to the contrast dye.

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