Intrahepatic biliary calculi (hepatolithiasis) are stones that form within the liver’s intrahepatic bile ducts. Most small or segmental stones are silent; symptoms appear when stones obstruct flow, provoke cholangitis, or lead to secondary biliary cirrhosis. Right-upper-quadrant painDull or colicky ache under the ribs, often recurrent and triggered by fatty meals; may radiate to the back or right shoulder. Cholangitis attacksIntermittent fever with chills, shaking rigors, and raised right-sided tenderness (Charcot triad) when stones block a segmental duct and become infected. JaundiceFluctuating yellowing of sclera and skin, dark urine, and pale stools occur as stones impact major intra-hepatic radicals or cause... Learn more