A case of common bile duct stones, failed ERCP and sensitivity to iodine contrast media: what contrast media should we use for an on-table cholangiogram?

摘要

A patient with common bile duct stones had a failed ERCP due to a duodenal diverticulum. However, she had a documented, florid, iodine-contrast media allergy. She proceeded to laparo-scopic cholecystectomy with common bile duct exploration. There-were concerns urograffin would provoke anaphylaxis.After discussion with radiology colleagues, we used gadolinium contrast. We diluted it to 50% with normal saline and then screened the syringe to ensure it provided adequate opacification. The cholangiogram images successfully demonstrated common bile duct stones which were removed laparoscopically.