An Obstructive Calculus in the Common Bile DuctClinical HistoryA 61 year old lady presented with an acute onset of epigastric pain and loss of appetite. The patient is known to have uncomplicated cholelithiasis which was diagnosed 2 decades ago. Presently, the bloods revealed raised alkaline phosphatase of 200.Case DescriptionAbdominal ultrasound revealed a distended gallbladder with multiple calculi. There was also intra and extrahepatic biliary dilatation present. The common bile duct measured 15 mm in AP calibre with a calculus (obstructive calculus) seen towards the distal end of the lumen. However, the pancreatic duct was not dilated.Diagnosis/ Discussion/ Treatment/ Follow upThe ultrasound findings were confirmed on a subsequent MRCP.SonogramsThe right hepatic lobe showing dilatation of the IHD and CBDLongitudinal section of the gallbladder containing multiple tiny calculiAn obstructive calculus in the distal CBDPublished on: September 18, 2024
