Choledocholithiasis

Case contributed by J. Ray Ballinger
Diagnosis certain

Presentation

Incidental finding during a workup for hematuria.

Patient Data

Age: 75 years
Gender: Female

Note: This case has been tagged as "legacy" as it no longer meets image preparation and/or other case publication guidelines.

mri

MR cholangiogram shows two filling defects in the distal common bile duct and one in the gallbladder. The common bile duct is prominent.

Case Discussion

Common bile duct stones can occur when a stone in the gallbladder passes through the cystic duct and tries to pass through the common bile duct. They can also form in situ within the bile ducts and so may be seen after surgical removal of the gallbladder.

Small stones in the common duct can be removed endoscopically with a sphincterotomy or percutaneously with a basket and/or balloon. Large ones may require lithotripsy or surgical removal.

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