Choledocholithiasis with double duct sign.

Choledocholithiasis with biliopathy.

Choledocholithiasis(multiple) with obstructive biliopathy.

Choledocholithiasis with obstructive biliopathy.

Choledocholithiasis with biliopathy.
Didn't find concomitant ampullary mass. It's a MUST to properly evaluate peri ampullary region on routine ultrasound.

Complete package.
Gall Bladder mass( carcinoma) at fundus + cholelithiasis(multiple) + choledocholithiasis(multiple).
Always be vigilant while scanning GB, nothing is 'easy peasy lemon squeezy'.
As they say' the more you know,imaging gets more complicated'.

Choledocholithiasis with biliopathy.
Properly evaluating common bile duct is a mundane task.
Every task is important,nothing is menial.

56 Yo with history of RnY gastric bypass presents with intermittent abdominal pain. Imaging revealed biliary ductal dilation and choledocholithiasis. Lap assisted ERCP failed due to significant adhesions. EDGE was successfully performed with complete ductal clearance. #GITwitter

Today case number 100 of choledocholithiasis and cholecistectomy one step! Proud of being in this amazing team 😊 Consorci Sanitari del Maresme Marina Vila

Choledocholithiasis (blue) after CCY. Cystic duct remnant (green), normal PD (orange) & stone-containing, dilated CBD. Post-CCY choledocholithiasis usually from retained or secondary stones from GB remnant or cystic duct, rarely from primary CBD stone formation.
#FOAMrad #radres

Easy to be distracted by choledocholithiasis.
Don't miss Cholecystocholedochal fistula.

Let's explore the Doubles.... #NEETPG #MedTwitter #MedX

1) Double barrel shotgun sign- dilated CBD secondary to choledocholithiasis becomes comparable to Portal vein on USG

Come check us out at #APSA2023 ! We are equipping ped surgeons to provide one stop mgt for choledocholithiasis

Cholelithiasis(multiple).
Blink an eye & you'll miss biliary pancreatitis( key is focus on mesenteric root edema & exudates in spleno renal recess).
Real culprit was choledocholithiasis.

Choledocholithiasis Plus

Choledocholithiasis

🎯 Presence of stone within the common bile duct
🎯 Present in 1-15% of gallstone patients
🎯 Jaundice, colicky pain, schools stools
🎯 elevated bilirubin, ggt, ALT and AST
🎯 Increased risk of pancreatitis, cholangitis
🎯 Prevalence increases with age

70y F👩‍🦳 with history of cirrhosis, choledocholithiasis,cholecystectomy and multiple ERCPs.

Diagnosis?

Choledocholithiasis Mukesh Harisinghani TAH Joaquín Martínez Sonographic_Tendencies

Octogenarian status post Billroth II surgery precluding ERCP for obstructive choledocholithiasis. Boston Scientific #SpyGlass percutaneous cholangioscopy & electrohydraulic lithotripsy for the win. #IRad

What I heard at grand rounds Humza Saleem. In experienced hands, Laparoscopic CBD exploration is as effective and safe as ERCP for choledocholithiasis with shorter hospital stay and decreased costs.