Choledocholithiasis and biliary obstruction

Case contributed by Dr Ahmed Abdrabou

Presentation

Right hypochondrial pain, jaundice and itching of 1 week duration

Patient Data

Age: 75 years
Gender: Male

A large stone returns low signal in all pulse sequence is seen impacted at the distal segment of CBD causing proximal dilatation of the CBD and intra hepatic biliary radicals

Diagnosis: CBD stone with proximal biliary obstruction

Case Discussion

Other DD of obstructive jaundice include periampullary carcinoma, cholangiocarcinoma and pancreatic head cancer. MRCP is best used in patients with impaired renal function and contrast sensitivity when CT is contraindicated.

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