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Choledocholithiasis is the presence of gallstones in the common bile duct, which can cause blockages and lead to infection and scarring. It can be resolved by a gastroenterologist, and is usually caused by bacterial infections or accumulations of cholesterol and calcium. Symptoms include abdominal pain, nausea, vomiting, and fever. Diagnosis is done through an abdominal ultrasound and endoscopic retrograde cholangiopancreatography (ERCP). Treatment involves breaking the blockage with fine instruments or surgery, and medication and checkups can prevent future cases.
Choledocholithiasis is a medical term that refers to the presence of gallstones in the common bile duct, which carries bile from the liver to the gallbladder and small intestine. A gallstone can form in the bile duct itself or travel from the gallbladder into the duct. Stones cause blockages that can lead to irritation, infection, and scarring of the bile ducts. Choledocholithiasis can usually be resolved by a gastroenterologist when the condition is discovered early.
A gallstone can be composed of cholesterol, calcified minerals, or bile pigment that has been hardened by bacteria. Stones that develop in the bile duct are usually the result of bacterial infections, while stones that migrate from the gallbladder are usually accumulations of cholesterol and calcium. The most significant risk factors for developing choledocholithiasis are being female, obese, and over the age of 60, although a person of any age and of either gender can have a gallstone.
In its early stages, choledocholithiasis may not cause any physical symptoms. When a stone grows and causes a blockage, a person is likely to experience sharp abdominal pains, nausea, vomiting, and fever. An individual may also lose their appetite and feel fatigued. Jaundice can arise when a blockage gets worse, and a total blockage presents the possibility of rupture, scarring, and infection. A person experiencing any possible symptoms of common choledocholithiasis should visit a doctor as soon as possible to avoid potentially life-threatening complications.
When a primary care physician suspects common choledocholithiasis, they will refer the patient to a specialist for a more detailed evaluation. A gastroenterologist usually does an abdominal ultrasound to look for a blockage and collects a blood sample to check for bile. Doctors often do an additional diagnostic test called endoscopic retrograde cholangiopancreatography (ERCP) to pinpoint the location of a gallstone and check for ruptures. During ERCP, a long tube called an endoscope is inserted down the throat and directed at the gallbladder to release a type of dye that can be detected on an X-ray.
Most cases of choledocholithiasis can also be treated with ERCP. The doctor feeds fine instruments through the endoscope to locate and break the blockage. A more invasive surgical procedure may be needed to remove a stone that is very large or is not fixed by ERCP. After surgery, the patient is usually given antibiotics and pain relievers and is usually re-evaluated to make sure that the gallbladder has not been damaged. A person who has a gallstone is at high risk of developing more stones in the future, although medication and frequent checkups can help prevent another case of common choledocholithiasis.
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