Common bile duct stone

Case contributed by Dr Ian Bickle

Presentation

Upper abdominal pain and deranged LFT's. Malignancy?

Patient Data

Age: 70 years
Gender: Female

The CBD is mildly dilated with a dense 5mm stone in the distal end.  Very mild intrahepatic duct dilatation.

Mildly thickened gallbladder containing stones.

Fatty liver.  The solid organs are otherwise unremarkable.

The radiodense stone is visible (red arrow) in the dilated distal CBD.

Case Discussion

CT is pretty much the 3rd in line investigations after ultrasound and MRI for the assessment of the biliary tree, in particular CBD stones.

However, cases of biliary obstruction may be revealed on CT performed for more indications.

The CBD stones can be seen when dense (as in the case) but are not always sensitive.

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