Cholelithiasis and choledocholithiasis

Case contributed by Dr Henry Knipe

Presentation

Right upper quadrant pain and deranged liver function tests.

Patient Data

Age: 35 years
Gender: Female

Gallbladder contains several small calculi and there are are at least 3 similar sized small calculi in the lower common bile duct which has a maximum diameter of 7 mm.

The gallbladder itself shows only mild focal tenderness. There is no gallbladder wall thickening and there is no pericholecystic fluid.

The liver is unremarkable. Both kidneys appear normal. Spleen size is normal.

Conclusion.

Cholelithiasis and choledocholelithiasis. No good evidence of cholecystitis.

Initial images show filling defect within the mid common bile duct and 2 stones were removed followed by a sphincterotomy.

Case Discussion

Choledocholithiasis is a not uncommon complication of cholelithiasis. Patient's can present with pain, jaundice, cholecystitis/cholangitis. 

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