Case contributed by Dr Kewal Arunkumar Mistry


Patient presented with colicky abdominal pain and mild icterus.

Patient Data

Age: 46 years
Gender: Female

Ultrasound of the upper abdomen shows multiple variable sized echogenic areas within the liver parenchyma. These areas demonstrate marked posterior acoustic shadowing and they are arranged in  a linear pattern along intrahepatic biliary radicles, compatible with hepatolithiasis.

The other possible etiology for this finding is gas in the intrahepatic biliary tree. These are more likely to be mobile on real time ultrasound imaging. If the diagnosis is uncertain, a CT scan would definitively answer the question.

Cholelithiasis is also noted.

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Case information

rID: 34795
Published: 8th Mar 2015
Last edited: 14th Aug 2019
Inclusion in quiz mode: Included

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