Choledocholithiasis

Causes and Risks:
About 15% of people with gallstones will develop the stones in the common bile duct, a small tube that carries bile from the gallbladder to the intestine. No symptoms will be present unless obstruction occurs. Even after the gallbladder is removed, a stone may remain in the common bile duct causing episodic pain. An obstruction in the common bile duct can also lead to an obstruction in the pancreatic duct because these ducts are connected in most people.

Risk factors include a previous medical history of cholelithiasis (gallstones). The incidence is 6 out of 100,000 people.

Prevention:
Prevention is unknown.

Symptoms:
  • abdominal pain in the upper right quadrant or the middle of the upper abdomen
    • may radiate to the right shoulder
    • may be sharp or cramping or dull
    • may be recurrent
    • may radiate to the back
    • made worse by fatty or greasy foods
    • occurs within minutes following meals

  • nausea
  • vomiting
  • fever
  • jaundice
  • appetite, loss



Signs and Tests:
Tests that show location of stones in the bile duct include:

Other blood tests that may be affected include:



Treatment:
The objective of treatment is to remove the obstruction in the bile duct. Surgical removal of the gallbladder and the stones may be recommended. Removal of the stones by ERCP , which is also a diagnostic procedure to determine the cause and location of obstruction, may be recommended where the procedure is available.

Prognosis:
Bile-duct blockage caused by stones in the biliary tract can be a life-threatening illness. With prompt diagnosis and treatment, the outcome is usually very good.

Complications:



Call Your Healthcare Provider:
Call for an appointment with your health care provider if abdominal pain develops that is not attributed to other causes, jaundice develops, or if other symptoms suggestive of choledocholithiasis develop.


This illustration shows the major organs of the digestive system. Their relative sizes and positioning in the body are also demonstrated.



A CT scan of the upper abdomen showing a fist-sized cyst of the left kidney and gallstones (the kidney cyst was found by chance; there were no symptoms).