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• W2914707130 abstract "Purpose: Here, we present an unusual case of a 78 y/o female presenting with significant weight loss, abdominal pain, jaundice and sitophobia. Her Past medical history was significan for osteoarthritis and hypertension. Physical Exam was remarkable for evidence of recent weight loss, mild icterus, a normal liver size and no peripheral lymphadenopathy. Laboratory investigations suggested cholestasis. Imaging studies included a contrast CT of abdomen showing Extrahepatic biliary obstruction and a 9 mm”mass” in the common bile duct with no evidence of any gall bladder stones. The patients Primary care Physician had requested tumor markers: CEA, and CA 19–9 Both were moderately elevated. The Patient was referred for an ERCP with a tentative diagnosis of Malignant Biliary Obstruction. However, on ERCP, surprisingly, the patient was found to have a 9 mm isolated common bile duct stone, the cystic duct was patent and no stones could be visualized in the gall bladder. An Endoscopic Sphincterotomy was done and the solitary CBD Stone was extracted. The patient had a sonogram the of the abdomen to definitively exclude gall bladder stones which confirmed absence of any stones in the gall bladder. Patient had a dramatic clinical improvment with resolution of her symptoms, recovery of her weight and normalization of her liver chemistries within a few weeks. Results: Here, we present an unusual case of 78 y/o female with significant weight loss, jaundice, and abdominal pain who on initial investigation of the complaints by a contrast CT of abdomen was reported to have a 9 mm mass in the common bile duct with no evidence of any gall bladder stones. A de novo solitary CBD stone was identified on ERCP and extracted. Conclusion: De novo stones of the common bile duct arise in the setting of 1) recurrent cholangitis 2) congenital anomalies like Caroli's disease 3) sclerosed or strictured ducts 4) very rarely due to mutations in MDR3 gene. Mostly common bile duct stones are a findings associated with cholelithiasis that is a stone arising in the gall bladder passes down the bile duct and becomes symptomatic. Solitary De novo CBD Stones may mimick Malignant biliary obstruction and may falsely elevate tumor markers." @default.
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• W2914707130 date "2007-09-01" @default.
• W2914707130 modified "2023-09-25" @default.
• W2914707130 title "De Novo Common Bile Duct Stones Mimicking Malignant Biliary Obstruction" @default.
• W2914707130 doi "https://doi.org/10.14309/00000434-200709002-00784" @default.
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