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Post-cholecystectomy partial biliary stricture leading to primary intrahepatic calculi
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  1. Saket Kumar,
  2. Rakesh Kumar Yadav,
  3. Abhijit Chandra
  1. Department of Surgical Gastroenterology, King George’s Medical University, Lucknow, Uttar Pradesh, India
  1. Correspondence to Dr Saket Kumar, krsaketsingh{at}gmail.com

https://doi.org/10.1136/bcr-2017-223653

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    Description

    A 40-year-old woman presented with complaints of pain in the right hypochondrium and intermittent high-grade fever with chills for 3 months. She had a history of waxing and waning jaundice for the last 2 months. She had undergone open cholecystectomy 15 years back. Abdominal examination revealed a non-tender hepatomegaly. Blood investigations showed a deranged liver function suggestive of obstructive biliary pathology. Total bilirubin level was raised (4.6 mg/dL) with predominant direct component (3.5 mg/dL). Her serum alkaline phosphatase was elevated (1683 U/L) but transaminase levels were within normal range.

    An abdominal ultrasound showed mild hepatomegaly with bilateral intrahepatic biliary radicle dilation. Multiple calculi were present in the intrahepatic bile ducts and a hypoechoic shadow was seen near hilum. In view of suspected mass lesion at hilum, an abdominal CT …

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    Footnotes

    • Contributors SK, RY, AC: concept and design of this work. SK, RY: preparation of the manuscript. SK, RY, AC: to take public responsibility for it and have agreed to have my/our name listed as a contributor. All authors (SK, RY, AC) have read and approved the final version of the manuscript.

    • Funding This research received no specific grant from any funding agency in the public, commercial or not-for-profit sectors.

    • Competing interests None declared.

    • Patient consent Obtained.

    • Provenance and peer review Not commissioned; externally peer reviewed.

    • Author note One of the authors (RY) does share the surname with the patient but they are not related or acquainted to each other. In fact, ‘Yadav’ is a common surname in the North Indian region.