The gentleman complained of progressive abdominal pain and presented with jaundice. As described above findings were consistent with choledochocele (choledochal cyst type III under the Todani classification system). On some of the sequences, there were multiple low signal intensity filling defects within the common duct including the distal duct. These were suspicious for common duct stones, even though they are not visualized on all pulse sequences. Gallstones were also noted. Choledocholithiasis is likely the cause of patients pain and jaundice.
ERCP was subsequently performed. The common bile duct stones were removed and a biliary stent was placed. This relieved the patient's pain and jaundice.