Bile Duct Stones: Making the Radiologic Diagnosis

Abstract

Bile duct stones are concretions of bile components that originate in the gallbladder as gallstones (cholelithiasis) and that are present in the biliary tree at the time of discovery. Most gall stones, if small enough, will pass through the cystic duct and the common bile duct (CBD) into the duodenum. Choledocholithiasis refers to stones in the common bile duct. These stones may lodge in the CBD and become impacted, thereby causing a blockage of the duct. Making the diagnosis of bile duct stones begins with a basic understanding of the biliary anatomy. Diagnosis by imaging can be made with a variety of modalities, most often by ultrasound (US), computed tomography (CT), or magnetic resonance imaging (MRI) and its cholangiographic adaptation (MRCP). Each modality has its relative advantages and shortcomings, and knowledge of the indirect and direct findings of choledocholithiasis, of the differential diagnosis of biliary dilatation and relative strengths of each imaging modality allows for accurate radiological diagnosis. However, one must be aware of the pitfalls of each modality to avoid misdiagnosis.

Keywords

Bile duct stones Biliary stones Common bile duct Gall stones Normal biliary anatomy Choledocholithiasis Cholangiocarcinoma Imaging the biliary tract MRCP CT MRI US Mirizzi’s syndrome 

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Copyright information

© Springer International Publishing Switzerland 2016

Authors and Affiliations

  1. 1.Department of RadiologyThe Ohio State University Wexner Medical CenterColumbusUSA

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