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Choledocholithiasis and biliary obstruction: a complication of sickle-cell disease.

Storm ESS - MedPix

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Affiliation: Uniformed Services University

ABSTRACT

Diagnosis: Choledocholithiasis and biliary obstruction: a complication of sickle-cell disease.

History: Jaundiced 14yo female with HbSS disease and worsening midepigastric pain.

Findings: Normal hepatic echotecture. Diffusely dilated intrahepatic bile ducts. Common duct at level of the crossing of the hepatic artery is >5mm, and the duct contains multiple echogenic stones. Small stone is lodged in the distal CBD, possibly at the ampulla. The gallbladder is filled approximately 1/2-2/3 full of sludge, however there is no evidence of inflammation.

Ddx: Idiopathic Hyperalimentation Hemolytic Disease Cystic Fibrosis Ileal Dysfunction

Dxhow: Patient is known to be HbSS positive.

Exam: Nontender to palpation. No fever, leukocytosis. Mild jaundice. UA: elevated bilirubin and urobilinogen. No RBC LFT: AST 160 H (14-50) U/L ALT 255 H (9-52) U/L ALKP 463 H (38-126) U/L DBIL 13.0 H (0.0-0.4) mg/dL C

No MeSH data available.


Transverse view of the pancreas showing a stone in the distal CBD, at or near the Ampulla of Vater.
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MPX2321_synpic23115: Transverse view of the pancreas showing a stone in the distal CBD, at or near the Ampulla of Vater.


Choledocholithiasis and biliary obstruction: a complication of sickle-cell disease.

Storm ESS - MedPix

Transverse view of the pancreas showing a stone in the distal CBD, at or near the Ampulla of Vater.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=MPX2321&req=5

MPX2321_synpic23115: Transverse view of the pancreas showing a stone in the distal CBD, at or near the Ampulla of Vater.

View Article: MedPix Image - MedPix Case

Affiliation: Uniformed Services University

ABSTRACT

Diagnosis: Choledocholithiasis and biliary obstruction: a complication of sickle-cell disease.

History: Jaundiced 14yo female with HbSS disease and worsening midepigastric pain.

Findings: Normal hepatic echotecture. Diffusely dilated intrahepatic bile ducts. Common duct at level of the crossing of the hepatic artery is >5mm, and the duct contains multiple echogenic stones. Small stone is lodged in the distal CBD, possibly at the ampulla. The gallbladder is filled approximately 1/2-2/3 full of sludge, however there is no evidence of inflammation.

Ddx: Idiopathic Hyperalimentation Hemolytic Disease Cystic Fibrosis Ileal Dysfunction

Dxhow: Patient is known to be HbSS positive.

Exam: Nontender to palpation. No fever, leukocytosis. Mild jaundice. UA: elevated bilirubin and urobilinogen. No RBC LFT: AST 160 H (14-50) U/L ALT 255 H (9-52) U/L ALKP 463 H (38-126) U/L DBIL 13.0 H (0.0-0.4) mg/dL C

No MeSH data available.