Presentation
Left upper quadrant pain.
Patient Data
Dextrocardia.
Reversal of situs of the abdominal organs.
Gallbladder, intrahepatic and extrahepatic ducts showing significant dilatation. Radiopaque stones in the distal common bile duct.
Patchy geographic regions of hypodensities within the liver parenchyma are also seen.
Degenerative changes along the imaged spine.
Case Discussion
Features are compatible with situs inversus and choledocholithiasis. In choledocholithiasis, patients may asymptomatic, however, they may present with ascending cholangitis, obstructive jaundice or acute pancreatitis.
Patchy geographic regions of hypodensities within the liver parenchyma could be early features of infection.
This case is contributed by Dr Naqibullah Foladi and Dr Mohammad Tahir Aien.