Choledocholithiasis

Low urgency
Common-

Presence of stones (gallstones) in the duct that carries bile from the liver and gallbladder to the intestine.

These stones are formed by bile pigments and calcium or cholesterol salts.

It manifests with pain in the upper right part of the abdomen, nausea, vomiting, fever, loss of appetite, yellow skin and clay-coloured stools.

After clinical suspicion, the diagnosis is confirmed by blood tests, an abdominal ultrasound and endoscopic retrograde cholangiopancreatography (ERCP).

Treatment consists of the gallstones removal through the ERCP or, if the percutaneous removal is not possible, surgical removal will be required.

Bibliographic references
  1. Mustafa A Arain, Martin L Freeman. Choledocholithiasis: Clinical manifestations, diagnosis, and management. UpToDate. Mar 13, 2015.
  2. Salam F Zakko. Uncomplicated gallstone disease in adults. UpToDate. Apr 21, 2016.
  3. Warttig S, Ward S, Rogers G, Guideline Development Group. Diagnosis and management of gallstone disease: summary of NICE guidance. BMJ 2014; 349:g6241.
  4. Johnson CD. ABC of the upper gastrointestinal tract. Upper abdominal pain: Gall bladder. BMJ 2001; 323:1170.
  5. E. Ros. Enfermedades de las vías biliares. Coledocolitiasis y colangitis. Farreras Rozman. Medicina Interna. Volumen I. Duodécima edición. 360:362.
  6. Norton J. Greenberger, Gustav Paumartner. Enfermedades de la vesícula biliar y las vías biliares. Coledocolitiasis. Harrison. Principios de Medicina Interna. Volumen 2. 19ª Edición. 2083:2084.
  7. María García Ávila, Ángel Blanco Bravo. Patología urgente de la vía biliar. Manual de protocolos y actuación en urgencias. Hospital Virgen de la Salud, Complejo Hospitalario de Toledo. Tercera edición. 2010.450.
Author
Dr. Oscar Garcia-Esquirol
Copyright
© TeckelMedical 2026

Symptoms

    Upper right abdominal pain


    Yellow tinge to skin and mucous membranes


    Abdominal pain radiating to the shoulder


    Pain for more than 20 minutes


    Nausea

Symptoms to watch out for

Fever (temperature higher than 38 ºC)
Skin's colouration change into yellow
Acute belly pain
Pain that doesn't subside with analgesics
Reduction in the level of consciousness

Self-care

Maintain a balanced diet: increase fruit, vegetable, and white meat consumption and reduce the intake of fatty meals and fritters.
Maintain hydration of 2 litres per day.
Consume over-the-counter pain relievers or anti-inflammatories.
Consume antiemetics if vomits are present.