Images in Clinical Medicine

Kim Eagle, M.D., Editor

Cholelithiasis and Choledocholithiasis

Alexandra L. Gibas, M.D., and Craig Philpot, M.D.

N Engl J Med 1993; 328:411February 11, 1993

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Article

Figure 1 Cholelithiasis and Choledocholithiasis.

An endoscopic retrograde cholangiogram from a 20-year-old woman with pain in the right upper quadrant and jaundice reveals stones in the left and right hepatic ducts (open arrows) and the common bile duct (small arrows) and multiple stones in the gallbladder (large arrow). The common bile duct is dilated, but the intrahepatic ducts are normal. A sphincterotomy was performed, the stones were extracted, and the patient had an uneventful laparoscopic cholecystectomy the following day.

Kim Eagle, M.D.

Alexandra L. Gibas, M.D.
Craig Philpot, M.D.
Case Western Reserve University, Cleveland, OH 44106