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Post cholecystectomy cystic duct stump and CBD stones

Case contributed by Faheemullah Khan
Diagnosis probable

Presentation

Right hypochondrial pain and jaundice since one month.

Patient Data

Age: 70 years
Gender: Male

Abdominal examination with a curvilinear array probe (3-5 MHz) in multiple views reveal dilated intra-hepatic biliary channels, dilated common bile duct (CBD) measuring up to 14 mm with an echogenic focus in the proximal CBD, dilated cystic duct stump with multiple echogenic foci. Head of pancreas appears normal. Note is made of excessive gut gases.

Case Discussion

This patient had undergone open cholecystectomy five years earlier. The indication was cholelithiasis. Recently, the patient developed pain in the right hypochondrium and obstructive jaundice. Cystic duct stump and CBD stones were revealed on ultrasound examination. The patient then underwent Magnetic Resonance Cholangiopancreatography (MRCP), which confirmed the sonographic findings. The MRCP images are not available.

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