A 90 year's old lady presented SQUARE HOSPITAL LTD Dhaka Bangladesh with obstructive jaundice, choledocholithiasis.

FINDINGS :

PAPILLA: A big juxtra papillary diverticulum is seen at the papilla. Bile flow seen.

PANCREATOGRAM: Not attempted.

CHOLANGIOGRAM: Selective cannulation could be done after needle papillotomy. Low union with common hepatic duct is noted. The CHD is dilated. Intrahepatic ducts are mildly dilated. Multiple filling defects consistence with stones is seen in the CBD and CHD. Gall bladder is well opacified and shows multiple filling defects. Papillotomy is extended by conventional papillotome followed by large balloon sphincteroplasty. Multiple blackish stones are extracted out by repeated balloon sweeping and the large stone is grasped by dormia basket and extracted out. Occlusion cholangiogram confirms complete clearance of stones from bile duct.

COMMENTS: Choledocholithiasis with cholelithiasis (Please see the description also).

THERAPEUTIC INTERVENTION: ERCP with papillotomy, balloon sphincteroplasty and stone extraction done.


Procedure performed by...............

Dr. Fowaz Hussain Shuvo
MBBS (DMC), MD (Hepatology)
Consultant-Gastroenterology & Hepatology
Interventional Gastroenterologist
SQUARE Hospitals Ltd.

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#choledocholithiasis #ercp_stone_extraction #obstructive_jaundice #cbd_stone

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