How do you tell if some one has choledochlithiasis?

Choledochlithiasis, or the presence of gallstones in the common bile duct, can present with various symptoms and signs. Here are some ways to tell if someone may have choledochlithiasis:

1. Abdominal Pain: Patients with choledochlithiasis often experience intense abdominal pain in the right upper quadrant or mid-abdomen. The pain can be sudden and sharp or persistent and achy.

2. Jaundice: Obstruction of the common bile duct by gallstones can lead to jaundice, a yellow discoloration of the skin, whites of the eyes, and mucous membranes. This occurs due to the buildup of bilirubin, a yellow pigment produced by the breakdown of red blood cells.

3. Dark Urine and Light Stool: The obstruction of the bile duct can interfere with the normal flow of bile into the intestines, leading to changes in stool and urine color. The stool may appear pale or clay-colored, while urine may become dark or amber due to increased bilirubin levels.

4. Itching (Pruritus): The accumulation of bile salts in the skin can cause intense itching, especially on the palms and soles. This is a common symptom of obstructive jaundice.

5. Nausea and Vomiting: Patients with choledochlithiasis may also experience nausea and vomiting. The pain and obstruction of the bile duct can trigger these symptoms.

6. Fever and Chills: In some cases, choledochlithiasis can cause inflammation of the bile ducts, leading to fever and chills. This occurs when the obstruction creates a favorable environment for bacterial growth and infection.

7. Abdominal Tenderness and Distension: The affected individual may experience tenderness upon palpation of the abdomen, particularly in the right upper quadrant. Bloating and abdominal distension can also be present.

However, it's important to note that these symptoms can be indicative of various other conditions, so a proper medical evaluation is essential for an accurate diagnosis of choledochlithiasis. A healthcare professional may order imaging tests, such as ultrasound, magnetic resonance cholangiopancreatography (MRCP), or endoscopic retrograde cholangiopancreatography (ERCP), to confirm the presence and location of gallstones.