Exclamation mark sign (limy bile)

Last revised by Vikas Shah on 9 Mar 2020

Citation, DOI, disclosures and article data

Citation:

Bell D, Shah V, Exclamation mark sign (limy bile). Reference article, Radiopaedia.org (Accessed on 24 Apr 2024) https://doi.org/10.53347/rID-74913

DOI:

https://doi.org/10.53347/rID-74913

Permalink:

https://radiopaedia.org/articles/74913

rID:

74913

Article created:

9 Mar 2020, Daniel J Bell ◉

Disclosures:

At the time the article was created Daniel J Bell had no recorded disclosures.

View Daniel J Bell's current disclosures

Last revised:

9 Mar 2020, Vikas Shah ◉

Disclosures:

At the time the article was last revised Vikas Shah had no recorded disclosures.

View Vikas Shah's current disclosures

Revisions:

2 times, by 2 contributors - see full revision history and disclosures

Systems:

Hepatobiliary

Sections:

Signs

Tags:

reference needed, cases

Synonyms:

Limy bile exclamation mark sign
Exclamation mark signs

The exclamation mark sign is a pathognomonic imaging sign of the rare diagnosis of limy bile on plain abdominal radiography. It occurs when there is both limy bile and a gallstone in the common bile duct. The linear vertical radiopaque bile forms the line of the exclamation mark (i.e. !), whilst a more distal calculus forms the 'dot' at the end of the exclamation mark ¹.