Choledocholithiasis denotes the presence of calculi within the extra- or intrahepatic bile ducts. Symptoms arise when a stone obstructs flow, triggers inflammation, or provokes infection. The presentation ranges from silent imaging findings to life-threatening sepsis. Biliary colicEpigastric or right-upper-quadrant pain begins 30–60 min post-prandially, peaks for ≥30 min, and radiates to the inter-scapular region or right shoulder. Movement does not relieve the discomfort, and analgesics are often required. Nausea and vomitingGastric stasis and vagal reflexes produce repeated retching that may transiently lessen pain. Fluctuating jaundiceIntermittent elevation of conjugated bilirubin produces scleral icterus, dark urine, and clay-coloured stools that wax and... Learn more