Presentation
Epigastric pain. Past history of papillary stenosis, treated with ERCP. US shows CBD = 12 mm.
Patient Data
Age: 80 years
Gender: Female
From the case:
Choledocholithiasis (CT IVC)
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CT cholangiogram chosen as patient is not jaundiced, 100 ml Biliscopin infused over 30 minutes.
CT cholangiogram showing gas in the dilated biliary tree from previous sphicterotomy, and stones in lower dilated CBD.
Case Discussion
CT cholangiography is a very useful examination for the detection of bile duct pathology if the serum bilirubin is less than 2x elevated. Beyond this level, the contrast agent is poorly excreted.
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