Blood tests and an abdominal MRI at Tam Anh General Hospital in Hanoi revealed slight dilation of Dong's bile ducts on both sides. His common bile duct, measuring 9 mm in diameter at one point, contained numerous small stones clustered into a 31 mm mass. His gallbladder also held multiple stones, the largest measuring 23x21 mm.

Dr. Vu Truong Khanh, Head of the Gastroenterology-Hepatology-Pancreatic Department at Tam Anh General Hospital in Hanoi, explained that stones from Dong's gallbladder had fallen into the common bile duct, causing blockage and dilation. This condition, left untreated, could lead to prolonged cholestasis, acute cholangitis, sepsis, and acute pancreatitis.

Dong was treated with antibiotics and underwent an endoscopic retrograde cholangiopancreatography (ERCP) to remove the stones. Once his condition stabilized, surgeons performed a laparoscopic cholecystectomy to prevent recurrence and complications.

During the ERCP, the medical team found that the opening of the bile duct (papilla of Vater) was located deep within a large diverticulum in the duodenum, making access challenging. Using advanced equipment, the team successfully flushed the bile duct, removed the stones, and placed a drainage stent. A month later, Dong underwent gallbladder removal surgery and recovered quickly.

The medical team performs an endoscopic retrograde cholangiopancreatography (ERCP) to remove Dong's gallstones. Photo: Tam Anh General Hospital

The medical team performs an endoscopic retrograde cholangiopancreatography (ERCP) to remove Dong's gallstones. Photo: Tam Anh General Hospital

According to Dr. Khanh, common bile duct stones often present with vague symptoms easily mistaken for common digestive disorders, leading to misdiagnosis. If someone experiences persistent dull or cramping pain in the right upper quadrant, especially if gastric treatment doesn't provide relief, they should seek specialized medical attention. Further investigations, including ultrasound, abdominal MRI, and ERCP, are crucial for accurate diagnosis and timely treatment.

Ly Nguyen

*The patient's name has been changed.