Intrahepatic biliary stones

Case contributed by Dr Subash Thapa

Presentation

Pain in the right hypochondrium, fever, and raised serum bilirubin level

Patient Data

Age: 35 years
Gender: Male

There are multiple echogenic structures of various sizes in the intrahepatic biliary ducts with posterior acoustic shadowing. There is dilation of intrahepatic biliary ducts.

Annotated image with arrows indicating the position of the intrahepatic stones. 

Case Discussion

Intrahepatic biliary stones are rare; it is common among patients with recurrent pyogenic cholangitis 1. Other conditions associated are underlining biliary anomalies such as Caroli disease, biliary atresiacystic fibrosis or previous biliary surgery.

The most common location of stones is in large-caliber ducts, mostly in the left hepatic lobe or posterior segment of the right hepatic lobe 1.

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