There is a large, dilated gallbladder to the right. The common bile duct has been opened to reveal the presence of multiple gallstones. There were also calculi within the gallbladder lumen and gallbladder neck. This is choledocholithiasis, a condition that occurs in about 10% of persons with cholelithiasis. It is rarely due to formation of calculi within intrahepatic or extrahepatic ducts, except in Asia where pigmented stones may form in association with infection by the liver fluke Opisthochis sinensis. Complications of choledocholithiasis include cholangitis, pancreatitis, secondary biliary cirrhosis, and hepatic abscess.
There were 89 correct entries out of 167 total entries for case 52.
| Our winner is: Allon Amitai of Tel Aviv, ISRAEL
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