Fluoroscopic image of multiple common bile duct stones seen at the time of ERCP and duodenoscope assisted cholangiopancreatoscopy(DACP). The stone was impacted in the distal common bile duct and was crushed with intracorporeal lithotripsy.
Choledocholithiasis is the presence of gallstones in the common bile duct. This condition causes jaundice and liver cell damage, and is a medical emergency, requiring the endoscopic retrograde cholangiopancreatography (ERCP) procedure or surgical treatment. A tendency for this disease can be inherited.
CauseWhile stones can frequently pass through the common bile duct into the duodenum, some stones may be too large to pass through the CBD and may cause an obstruction. ComplicationsThis obstruction leads to jaundice, elevation in alkaline phosphatase, increase in conjugated bilirubin in the blood and increase in cholesterol in the blood. It can also cause acute pancreatitis and ascending cholangitis. Diagnosis
MRCP image of two stones in the distal common bile duct
Doctors can use a blood test of alkaline phosphatase, bilirubin and cholesterol to diagnose choledocholithiasis. However, ultrasound demonstrating an enlarged common bile duct is the test of choice. TreatmentTreatment involves removing the stone using ERCP. Typically, the gallbladder is then removed to prevent a future occurrence of common bile duct obstruction.
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