An Obstructive Calculus in the Common Bile Duct Clinical History A 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 Description Abdominal 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 up The ultrasound findings were confirmed on a subsequent MRCP. Sonograms The right hepatic lobe showing dilatation of the IHD and CBD Longitudinal section of the gallbladder containing multiple tiny calculi An obstructive calculus in the distal CBD Published on: September 18, 2024
