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Abdomen » Hepatobiliary
Choledocholithiasis and Cholelithiasis
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Author(s) :
Chaitali Shah, FRCR
 
Presentation A 56-year-old male presents with a history of alcohol abuse and dull pain in the upper abdomen. An ultrasound of the abdomen was performed.
 
 
 
Caption: Oblique scan of the liver
Description: There are multiple echogenic foci seen throughout the intrahepatic biliary system, consistent with the diagnosis of pneumobilia.
 
 
 
Caption: Transverse scan of right upper quadrant
Description: The common bile duct is dilated and shows the presence of an echogenic calculus. There is no associated wall thickening.
 
 
 
Caption: Sagittal scan of upper abdomen
Description: The CBD calculus is marked by calipers.
 
 
 
Caption: View of the distal portion of the CBD
Description: Several tiny calculi are seen in this view of the dilated CBD.
 
 
 
Caption: Sagittal view of the gallbladder
Description: The gall bladder is distended and filled with sludge. Scattered tiny echogenic calculi are also seen. There is no associated thickening of the bladder wall.
 
 
 
Caption: Transverse image of the gall bladder
Description: Cholelithiasis and sludge within the gall bladder are noted.
 
Differential Diagnosis Choledocholithiasis and cholelithiasis with pneumobilia
 
Final Diagnosis Choledocholithiasis and cholelithiasis with pneumobilia
 
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