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Choledocholithiasis

Case contributed by Dr Roberto Schubert

Presentation:

Sudden-onset upper right quadrant and mid-abdominal pain for 3 days.

Patient Data:

Age: 71
Gender: Male
Race: Caucasian
Modality: CT

Dilated intra- and extrahepatic bile ducts (D. choledochus 15 mm). 17 mm obstructive, mixed  gallstone near the papilla. Probably more mixed or cholesterol stones in the gallbladder. Myelolipoma of the left adrenal. Several renal cysts (atypically hyperdense one at the left lower pole).

Case Discussion:

Stones with only minor or without calcifications are difficult to see on CT. The common bile duct stone in this case is typical for the mixed type of gallstones.

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