PMC4531647_01
Ultrasonographic examination of the abdomen revealed marked dilation of extrahepatic bile duct and both intrahepatic ducts and a large echogenic density (20x48 mm) was demonstrated in the common bile duct, casting a shadow
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On abdominal ultrasound examination, a large echogenic density (20x48 mm) was demonstrated in the common bile duct, which casted a shadow (Figure 1).
A & B. ERCP demonstrates dilated extrahepatic bile duct and left intrahepatic bile duct. Note a large elongated filling defect with a central metal stent in the extrahepatic bile duct.
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ERCP revealed the dilated extrahepatic bile duct and left intrahepatic bile duct and the presence of a large elongated freely mobile filling defect suggestive of common bile duct stone containing metal mesh in the distal common bile duct (Figure 2).
The picture shows the exposed metallic stent conglomerated with the fragments of stone (left) and the distorted covered metal stent with polytetrafluoethylene [PTFE] material after washing (right).
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The removed stone was soft and dark brown in color (Figure 3A), with metal stent extruding from the ampulla of Vater along with common bile duct stone fragments (Figure 3B).