case_images: PMC5591995_01
case_images: ERCP showing multiple CBD stones. Note that the right hepatic duct is not visualized due to obstruction.
case_images: CRIGM2017-8575674.001.jpg
case_images: PMC5591995_01_CRIGM2017-8575674.001.jpg
case_images: fig1
case_images: She was started on IV antibiotics and had an urgent endoscopic retrograde cholangiopancreatography (ERCP) which demonstrated a common bile duct (CBD) stones with multiple intrahepatic stones as well (Figure 1).
case_images: Percutaneous cholangiogram showing multiple stones in biliary tree.
case_images: CRIGM2017-8575674.002.jpg
case_images: PMC5591995_01_CRIGM2017-8575674.002.jpg
case_images: fig2
case_images: Also, the right intrahepatic duct drain was placed by interventional radiology (Figure 2).
case_images: CT scan showing calcified stones within dilated intrahepatic ducts in the left lobe of the liver.
case_images: CRIGM2017-8575674.003.jpg
case_images: PMC5591995_01_CRIGM2017-8575674.003.jpg
case_images: fig3
case_images: An abdominal computer tomography (CT) scan with contrast showed stones within intrahepatic ducts on the left lobe of the liver (Figure 3).
case_images: Cholangioscope image showing intrahepatic stone.
case_images: CRIGM2017-8575674.004.jpg
case_images: PMC5591995_01_CRIGM2017-8575674.004.jpg
case_images: fig4
case_images: Then cholangioscope was introduced through the sheath and electrohydraulic lithotripsy (EHL) was done under direct visualization (Figure 4) and stones were basketed from the left intrahepatic system.
case_images: Percutaneous cholangiogram showing biliary tree after the procedure.
case_images: CRIGM2017-8575674.005.jpg
case_images: PMC5591995_01_CRIGM2017-8575674.005.jpg
case_images: fig5
case_images: Cholangiogram showed no residual stones (Figure 5).