Case contributed by Dr David Holcdorf


Sudden onset epigastric pain. Elevated transaminases and bilirubin.

Patient Data

Age: 80 years old
Gender: Female

The gallbladder appears mildly distended, and the common hepatic and common bile duct diameter are at the upper limit of normal. There is a calcific focus measuring 3mm in the distal common bile duct at the level of the pancreatic head. No further gallstones are identified in the gallbladder. Pancreas appears unremarkable, with no peripancreatic fat stranding seen.


Findings are in keeping with choledocholithiasis.

Case Discussion

Choledochlithiasis is a relatively common presentation, and occurs when a gallstone becomes lodged in the extrahepatic bile ducts causing obstruction resulting in pain and abnormal liver function tests.

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Case information

rID: 45079
Published: 14th May 2016
Last edited: 14th Aug 2019
Inclusion in quiz mode: Included

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