Choledocholithiasis has which potential complications?

• A. Duodenal ulcer disease
• B. Cholecystitis
• C. Acute pancreatitis and acute cholangitis
• D. Hepatic encephalopathy

Answer: (C)

When a stone blocks the common bile duct, bile flow is obstructed and pressure builds up in the biliary system. This sets up two major problems: infection of the biliary tree and impaired drainage of pancreatic secretions. The obstruction at the level of the ampulla can cause pancreatitis because pancreatic enzymes can back up and become activated within the pancreas. It can also lead to acute cholangitis, an infection of the bile ducts, due to stasis and bacterial ascent from the duodenum.

These are the typical complications of choledocholithiasis because the ductal obstruction directly affects both biliary drainage and pancreatic outflow, making infection and inflammation of the biliary system as well as pancreatitis likely outcomes.

Duodenal ulcer disease is unrelated to biliary obstruction and stems from acid-peptic processes. Cholecystitis would stem from obstruction of the cystic duct by gallstones in the gallbladder, not from stones in the common bile duct. Hepatic encephalopathy arises from severe liver dysfunction or failure, not from a ductal stone obstruction.