Choledocholithiasis
Choledocholithiasis represents the presence of stones in the bile ducts. Вiliary obstruction leads to secondary infection the disease is called cholangitis. The stones of the bile duct (choledocholithiasis) is a common form of gallstone disease, usually associated with gallstones it leads to serious complications. The stones of the bile duct coming from the gallbladder, but can also form in the bile ducts.
The most common microorganisms causing cholangitis are Escherichia coli, Klebsiella, Enterobacter, and rarely Enterococcus, Bacteroides, Clostridia and others.
The obstruction of the bile duct leads to the development of mechanical jaundice. When blockage of bile ducts develop inflammation and leads to the development of cholangitis, which proceeds with jaundice, pain and temperature rise of chills- the triad of Charcot. The stones of the bile duct can pass into duodenum and then there is no clinical symptomatology. In severe cases develop shock and there is loss of consciousness of the patient that is pentad of Reynolds. Other complications include: cholangiohepatitis, abscesses of the liver, pancreatitis and others.
Diagnosis:
- Ultrasound of abdomen
- Computed tomography
- Nuclear magnetic resonance
Treatment
Endoscopic retrograde cholangiopancreatography (ERCP) with performing sphincterotomy and extraction of concretions (bloodless treatment). Surgical treatment – choledochotomy and extraction of concretions by placing a drainage to the method of Kerr or performing choledocho-duodenoanastomosis.