Presentation
Prior cholecystectomy due to gallstones, occasional RUQ discomfort, ERCP planned.
Patient Data
Age: 40 years
Gender: Female
From the case:
Intrahepatic bile duct stone
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A non-occlusive stone with a maximum diameter of approximately 4-5 mm, demonstrating posterior acoustic shadowing can be seen centrally in an intrahepatic bile duct of the right lobe. The common bile duct diameter (5-6 mm) and the intrahepatic bile ducts are within normal limits.
From the case:
Intrahepatic bile duct stone
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The pathology can be better appreciated in the cine loop.
Case Discussion
A subtle case of hepatolithiasis which required careful scrutiny, especially as no other alarming signs such as distal intrahepatic bile duct dilatation were present. The posterior acoustic shadowing is a particularly helpful sign when searching for similar, smaller stones.