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Endoscopy 1990; 22(2): 85-87
DOI: 10.1055/s-2007-1012801
© Georg Thieme Verlag KG Stuttgart · New York

Cystic Duct Entry - Another Cause of Pseudocalculus

I. Berkowitz1 , P. C. Bornman1 , R. E. Kottler2
  • 1Gastrointestinal Clinic, Groote Schuur Hospital/University of Cape Town, South Africa
  • 2Radiology Department, Groote Schuur Hospital/University of Cape Town, South Africa
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Publication History

Publication Date:
17 March 2008 (online)

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Summary

Certain pitfalls face the endoscopist during ERC in the diagnosis of common bile duct stones. Falsepositive filling defects for calculi may be caused by air bubbles, blood clot, tumor, and the pseudocalculus sign of the lower common bile duct (CBD) due to sphincter spasm. Another false positive may be encountered by the presence of a filling defect at the confluence of the cystic duct and common bile duct, and we report on three such cases. The cause of this pseudocalculus sign of the mid-CBD is not clear. We speculate that it may arise as a result of an unopacified jet of bile flowing from the cystic duct displacing contrast in the CBD.

Key words:

Endoscopy - Common bile duct - Cystic duct - Pseudocalculus

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