Cystic duct stump stones (residual post cholecystectomy)

Case contributed by Bruno Di Muzio
Diagnosis almost certain

Presentation

5 days after cholecystectomy. Persistent symptoms of vague upper quadrant pain.

Patient Data

Age: 40 years
Gender: Female

Within the distal cystic duct stump, there is a rounded filling defect showing low attenuation that is highly concerning for residual cystic duct stone; hematoma would be expected to have a more amorphous shape and elevated attenuation. Otherwise, this study shows only expected post cholecystectomy appearance, and no other filling defect in the biliary tree.

MRCP confirms with better resolution the filling defects in the cystic duct, thought to be related to residual stones.

Case Discussion

This case illustrates of residual stones in the cystic duct after laparoscopic cholecystectomy. 

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