Choledocholithiasis (MRCP and ERCP)

Case contributed by Dr Henry Knipe

Presentation

Jaundice.

Patient Data

Age: 70 years
Gender: Male

Cholelithiasis with choledocholithiasis. Common bile duct is dilated measuring 13 mm with mild intrahepatic duct dilatation. Phrygian cap. Simple liver segment 6 liver cyst. 

Fluoroscopy

Multiple filling defects with the common bile duct in keeping with choledocholithiasis. 

Case Discussion

MRCP is used as a non-invasive method of confirming choledocholithiasis or investigating those with biliary dilatation. Ultrasound is still the first-line screening modality. ERCP can be used for diagnosis but is usually reserved for treatment given the relatively high rate of complications (namely post ERCP pancreatitis). 

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