Causes and risk factors
Common bile duct is a small tube that carries bile from the gallbladder to the intestine. Risk factors for choledocholithiaisis include history of gallstones, removal of gallbladder. Obstructive jaundice can also lead to the condition.
Clinical presentation
Symptoms occur when the stone blocks the common bile duct. These include abdominal pain in the right upper or middle upper abdomen, which may be steady, cramping, dull, and may spread to the back or below the right shoulder blade. Accompanied symptoms include fever, loss of appetite, jaundice, nausea, and vomiting.
Investigation
Medical history by the patient and clinical examination by the doctor helps in diagnosis. Blood tests for complete blood count, serum bilirubin, liver function tests, pancreatic enzymes are recommended. Tests that can locate the stones in the bile duct include abdominal CT scan, abdominal ultrasound, endoscopic retrograde cholangiopancreatography [ERCP], endoscopic ultrasound, magnetic resonance cholangiopancreatography [MRCP], percutaneous transhepatic cholangiogram [PTCA].
Treatment
The treatment of choledocholithiaisis is aimed at removal of the blockage. It involves surgery to remove the gallbladder and stones. ERCP and sphincterotomy is a procedure which makes a surgical cut into the muscle in the common bile duct to allow stones to pass or be removed.
Facts and figures
Among the patients with gallstones, 15% of such patients will develop stones in the common bile duct.
