Choledocholithiasis

Case contributed by Dr Mohammad Taghi Niknejad

Presentation

Abdominal pain.

Patient Data

Age: 80 years
Gender: Female

Intra and extrahepatic bile ducts are dilated and CBD measured 15 mm in caliber. A 10 mm low signal filling defect is present at distal third of CBD inferring stone.
A 48mm parapelvic cyst is present at right kidney.

Case Discussion

Magnetic resonance cholangiopancreatography (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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