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 25 June 2018

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HepatologyBiliary tract


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Solitary gall stone.
A 41-year-old woman admitted with gallstone-related acute pancreatitis. The ultrasound revealed a solitary 3 cm stone in the gallbladder on the CT. The CT shows a swollen pancreas, but the stone was not visible. The patient underwent a laparoscopic cholecystectomy. A solitary oval stone was found in the gallbladder. The stone was put in a beaker of water and CT-scanned, it was barely visible.

Comment: Gallstones are said to produce pancreatitis when they transit the common bile duct and pass through the sphincter of Oddi. This would not appear to be the case in this patient. Is there another mechanism of triggering pancreatitis - or is the presence of the gallstone merely coincidental? The other point illustrated by this case is the unreliability of CT in the detection of gallstones - this gallstone was of similar density to water.


Peter Devitt, Adelaide, Australia

Solitary gall stone.

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