Biliary Lithiasis in a Patient with Crohn's Desease? Not Always As It Seems.

Abstract

We present the case of a 61 year old male with a history of Crohn's disease on which plain abdominal x-ray, incidentaly found a large rounded radiopaque image with multiple images inside a level of the right upper quadrant. 

Abdominal CT scan showed an area of stenosis in the transverse colon and a prestenotic area in the right upper quadrant level, dilated inside with fecaloid material with multiple hyperdense images consistent with fecaliths. 

Although we know that abdominal ultrasound is more sensitive than plain x-ray of the abdomen to detect gallstones, we often tend to assume this diagnosis at first glance.