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CBD STONES

Gastroenterology

CBD STONES

1. ALP and bilirubin are generally not elevated in typical cholecystitis because the gallstones block only the exit to the gallbladder.

2. Increasing ALP and bilirubin (bilirubin > 4 mg/dL) suggest the presence of a common duct stone.

3. Consider CBD stones in patients with increased ALP and bilirubin or the post-cholecystectomy patient with persistent pain.

4. Common duct blockage also can cause cholangitis.

5. Common duct stones are removed by ERCP with +/- endoscopic sphincterotomy.


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REFERENCES

1. Wilkinson, I. (2017). Oxford handbook of clinical medicine. Oxford: Oxford University Press.
2. Hannaman, R. A., Bullock, L., Hatchell, C. A., & Yoffe, M. (2016). Internal medicine review core curriculum, 2017-2018. CO Springs, CO: MedStudy.
3. Image: no reference available.

Ⓒ A. Manickam 2018

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