Presentation
Right hypochondrium pain and raised serum bilirubin level. History of cholecystectomy with choledochojujenustomy.
Patient Data
Age: 60 years
Gender: Male
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Sizable intrahepatic stone (5.5 x 3 cm) casting and extending into the central aspects of the right and left biliary ducts branches bilaterally more marked on the left side associated with marked bilateral intrahepatic biliary dilatation, extending to the common hepatic duct reaching the choleducojujenostomy.
Status post cholecystectomy.
Multiple bilateral renal small simple cysts.
Case Discussion
Features are consistent with large intrahepatic biliary stone with central intrahepatic biliary obstruction. It is a rare condition and most commonly located in large-caliber ducts.
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