Acute choledocholithiasis

Just as acute cholecystitis can be diagnosed by CT, so can acute choledocholithiasis. Both calcified (Fig. 1) and cholesterol (Fig. 2) calculi can be picked up. Cholesterol calculi may be difficult to see sometimes, especially in a non-dilated system, but subtle changes in density in the CBD should be looked for. MRCP of course in this setting is even more sensitive (Fig. 3) and all calculi can be seen as filling defects.