Choledocholithiasis

Case contributed by Dr Mohammad Taghi Niknejad

Presentation

Abdominal pain.

Patient Data

Age: 90 years
Gender: Female

Extra and central intrahepatic bile ducts are dilated and CBD measured 12mm in caliber. Several small low signal filling defects are seen at distal of CBD inferring stone. Additionally, the gallbladder is of normal volume and contains a few small low signal filling defects compatible with gallstones. 
Several cortical cysts are seen at kidneys less than 55mm.

Case Discussion

Findings are compatible with choledocholithiasis & cholelithiasis.
MRCP has largely replaced ERCP as the gold standard for diagnosis of choledocholithiasis, able to achieve similar sensitivity (90-94%) and specificity (95-99%) without ionizing radiation, intravenous contrast, or the complication rate inherent in ERCP.

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