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As noted , in that portion of its opinion , the Court held that the Nebraska statute applied , not only to the " dilation and extraction " or D & X procedure , but also to the more commonly used D & E procedure . Limited evidence suggests that the following techniques have similar stone removal rates and short-term complications : intracorporeal and extracorporeal lithotripsy methods for removing large common bile duct stones ; balloon dilation and sphincterotomy ; and needle-knife fistulotomy and needle-knife precut papillotomy . Oreshoots usually indicate zones of dilation and high fluid flow , as well as unique rock chemistry . Morphologic distinction of the two gynecologic neoplasms can be difficult when the tumor involves the lower uterine segment or upper endocervix , when the adenocarcinoma is present in both components of a fractional dilation and curettage ( D & C ) specimen , or when there is no in-situ component , cervical glandular intraepithelial ( CGIN ) , cervical intraepithelial neoplasia ( CIN ) , or endometrial hyperplasia [ 3,4 ] . Vessels that wrap around the UPJ may be associated with obstruction or can be a product of renal dilation and hydronephrosis that distorts renal vascular architecture .