PMC5591995_01
ERCP showing multiple CBD stones. Note that the right hepatic duct is not visualized due to obstruction.
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She was started on IV antibiotics and had an urgent endoscopic retrograde cholangiopancreatography (ERCP) which demonstrated a common bile duct (CBD) stones with multiple intrahepatic stones as well (Figure 1).
Percutaneous cholangiogram showing multiple stones in biliary tree.
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Also, the right intrahepatic duct drain was placed by interventional radiology (Figure 2).
CT scan showing calcified stones within dilated intrahepatic ducts in the left lobe of the liver.
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An abdominal computer tomography (CT) scan with contrast showed stones within intrahepatic ducts on the left lobe of the liver (Figure 3).
Cholangioscope image showing intrahepatic stone.
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Then cholangioscope was introduced through the sheath and electrohydraulic lithotripsy (EHL) was done under direct visualization (Figure 4) and stones were basketed from the left intrahepatic system.
Percutaneous cholangiogram showing biliary tree after the procedure.
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Cholangiogram showed no residual stones (Figure 5).