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Choledocholithiasis
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- Choledocholithias occurs when gallstones become stuck in the common bile duct, which connects the gallbladder and pancreas to the intestine. Cholangitis occurs
when the common bile duct becomes infected.
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- Sudden, severe pain in middle upper
abdomen
- Pain may radiate to right shoulder
- Occasionally painless
- Fever
- Chills
- Nausea/vomiting
- Severe case
- Confusion
- Lethargy
- Low Blood Pressure
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- Tenderness in middle upper
abdomen
- Yellow skin or eyes
- Elevated Bilirubin level
- Bilirubin in urine
- Elevated Alkaline phosphatase
- Amylase may be
elevated
- ALT, AST (liver tests) may be
elevated
- Prolonged Prothrombin time
may occur
- Ultrasound
- CT scan
- Radio-nuclide scan
- ERCP (test passing a scope down
the esophagus and into the opening of the common bile
duct) -- ERCP can be used remove an obstructed
stone.
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- Antibiotics intravenously
- Vitamin K if clotting problems are
present
- Stone removal by ERCP (see above)
- Lithotripsy (sound waves used to
break apart) may be useful in some cases.
- Biliary stenting (drainage tube
placed in common bile duct) if necessary
- Surgery if
necessary
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- Biliary Cirrhosis --
permanent damage to liver can occur especially if untreated.
- Bleeding problems -- because the
liver's ability to make clotting factors is
damaged.
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