MRI abdomen and MRCP findings in choledocholithiasis with obstructive jaundice and cholangitis: A case report

Abstract

Choledocholithiasis refers to the presence of solid round stones (Particles) in the extrahepatic bile duct, specifically the common bile duct. It is the second most prevalent complication associated with common biliary duct (CBD) disease, affecting approximately 10-15% of patients with CBD. A case report of a 53-years-old male patient with choledocholithiasis, accompanied by obstructive jaundice and cholangitis, was conducted using abdominal MRI with MRCP at Bethesda Hospital in Yogyakarta. A 53-years-old male patient arrived at Bethesda Hospital in Yogyakarta, reporting yellowing of the eyes and itching for more than two weeks. Supporting examinations revealed elevated levels of total bilirubin, indirect bilirubin, SGPT, SGOT, and alkaline phosphatase, all exceeding normal reference values. On the non-contrast abdominal MRI with MRCP, the intrahepatic bile duct system appeared prominent, while the gall bladder appeared slightly prominent with uneven thickening of the walls. The cystic duct showed relatively uneven walls, and the common bile duct appeared prominent with slightly irregular luminal wall and a hypointense signal filling defect in the distal part. The diagnosis can be made using non-contrast abdominal MRI with MRCP. The findings from the imaging modalities show prominence of the biliary system, including the extrahepatic bile duct, with thickening and uneven walls. Additionally, a hypointense signal filling defect is observed in the distal part of the common bile duct. Based on the examination results, the impression is that there is a stone in the common bile duct, accompanied by obstructive jaundice and cholangitis.