Choledocholithiasis

Case contributed by Dr Mohammad Taghi Niknejad

Presentation

Post cholecystectomy abdominal pain.

Patient Data

Age: 55 years
Gender: Male
ct

The gallbladder is not seen at anatomical location due to prior resection. Intra and extrahepatic bile ducts are dilated and CBD measured 16 mm in caliber. 
Mild degenerative changes as osteophytosis are seen at the lumbar spine.

mri

The gallbladder is not seen at anatomical location due to prior resection.
Intra and extrahepatic bile ducts are dilated and CBD measured 15 mm in caliber. A 12 mm low signal filling defect is noted at distal of CBD inferring stone.

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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