Choledocholithiasis

WHAT IS IT?

Choledocholithiasis is a condition characterized by a gall stone that is impacted in the common bile duct (also called common bile duct stone).

WHAT IS THE INTIAL PRESENTATION FOR THIS CONDITION?

Patient Issues/Chief Complaints:

• Jaundice
• Abdominal pain: can be in the RUQ

Detection On Medical Workup:

• Elevated bilirubin often present in serum studies.

WHAT ARE IMPORTANT FEATURES OF THE PHYSICAL EXAM?

Vital Signs:

• No fever should be present in this condition

CLINICAL WORKUP:SERUM STUDIES

Complete Metabolic Panel (CMP):

• Elevated serum bilirubin: direct will often be elevated, however indirect can be elevated as well.

CLINICAL WORKUP:IMAGING

Transabdominal ultrasound:

• Can visualize the stone in the common bile duct.
• If negative will not rule out this condition (may not be able to visualize the stone by this means.

MRCP:

• Can be used in the setting of a equivocal ultrasound to diagnose this condition.

HOW DO WE MANAGE A PATIENT WITH THIS DIAGNOSIS?

ERCP can be used to remove the stone.

ARCHIVE OF STANDARDIZED EXAM QUESTIONS 

This archive compiles standardized exam questions that relate to this topic.

Page Updated: 01.22.2017