The misdiagnosis of common bile duct stones with ultrasound

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Abstract
Ultrasound is now widely used to demonstrate the presence of gall stones in the gall bladder and common bile duct in jaundiced patients. The ultrasound appearance of gall stones is characteristic and consists of strong, bright reflections with shadowing distally, although stones smaller than 3 or 4 mm may not always show shadowing. Experience with large common bile duct stones which do not show the characteristic features of gall stones and may be misdiagnosed as tumor masses is reported. The possible reasons for these appearances are discussed.
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