Obstructive jaundice caused by obstructing biliary stone is commonly seen at the common bile duct. Obstructive jaundice by an ampullary lesion is commonly due to a neoplastic lesion rather than an obstructing stone.

An impacted stone at Ampulla of Vater is a less common cause and it is best demonstrated by CT. This is usually associated with dilated CBD, pancreatic duct and intrahepatic biliary radicals dilatation.

In this case, pancreas divisum is also noted (a normal variant).

It is considered an emergency condition that can be complicated with Acute cholangitis or acute pancreatitis due to complete obstruction of the biliary system.