Choledocholithiasis

Case contributed by Varun Babu
Diagnosis certain

Presentation

Recurrent right upper abdominal pain with cholestasis.

Patient Data

Age: 75 years
Gender: Male
mri
This study is a stack
Coronal
T2
This study is a stack
Coronal T2
fat sat
This study is a stack
Axial T2
fat sat
This study is a stack
Axial
T2
This study is a stack
Axial T2
fat sat
This study is a stack
Axial
DWI
This study is a stack
3D
MRCP
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Info

Prominent common bile duct with four stones seen in tandem in the distal half of the duct. No significant upstream dilatation in intrahepatic biliary tree. Normal pancreatic and cystic ductal system. Two to three stones also seen in gall bladder. 

Case Discussion

A typical case of gallstones and choledochal stones causing recurrent upper abdominal pain. It is important to rule out any early signs of biliary duct neoplasm in long standing cases of calcular disease. No such signs of biliary tree mural thickening nor any intra hepatic mass lesions were identified in this study. 

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