Hepatolithiasis or intrahepatic duct stones is uncommon in western setting, but it has quite a high prevalence in far eastern countries. The natural history of the disease may not be well understood in a western society, however due to increasing immigration, there are increasing numbers of cases that have occurred and will only continue occurring. The case report is regarding an elderly lady with previous complicated cholecystectomy presented with worsening recurrent right upper quadrant pain. Computed tomography (CT) and magnetic resonance imaging (MRI) interestingly revealed multiple intraductal hepatolithiasis. The aim of imaging should be to accurately identify the biliary tree and liver anatomy, stones, stricture, liver segment involved and excluding complication such as abscesses or cholangiocarcinoma.
References
[1]
Adhikari, L., Achhami, E., Bhattarai, N., Kandel, A. and Shrestha, A.B. (2022) Diagnosis and Management of Hepatolithiasis in an Adult Patient: A Case Report. Annals of Medicine and Surgery, 82, 104788. https://doi.org/10.1016/j.amsu.2022.104788
[2]
Sakpal, S.V., Babel, N. and Chamberlain, R.S. (2009) Surgical Management of Hepatolithiasis. HPB, 11, 194-202. https://doi.org/10.1111/j.1477-2574.2009.00046.x
[3]
Chan, F.L., Chan, J.K. and Leong, L.L. (1997) Modern Imaging in the Evaluation of Hepatolithiasis. Hepatogastroenterology, 44, 358-369.
[4]
Jo, J.H., Chung, M.J., Park, J.Y., Bang, S., et al. (2013) High Serum CA19-9 Levels Are Associated with an Increased Risk of Cholangiocarcinoma in Patients with Intrahepatic Duct Stones: A Case-Control Study. Surgical Endoscopy, 27, 4210-4216. https://doi.org/10.1007/s00464-013-3025-1
[5]
Kim, H.J., Kim, J.S., Joo, M.K., Lee, B.J., Kim, J.H., et al. (2015) Hepatolithiasis and Intrahepatic Cholangiocarcinoma: A Review. World Journal of Gastroenterology, 21, 13418-13431. https://doi.org/10.3748/wjg.v21.i48.13418
[6]
Sainani, N.I., Catalano, O.A., Holalkere, N.S., Zhu, A.X., Hahn, P.F., et al. (2008) Cholangiocarcinoma: Current and Novel Imaging Techniques. Radiographics, 28, 1263-1287. https://doi.org/10.1148/rg.285075183
[7]
Lan, B.Y., Kwee, S.A. and Wong, L.L. (2012) Positron Emission Tomography in Hepatobiliary and Pancreatic Malignancies: A Review. The American Journal of Surgery, 204, 232-241. https://doi.org/10.1016/j.amjsurg.2011.07.025
