Medical MCQ - A 30-year-old patient complains of pain abdomen for 5 days, with similar history in recent past as well. On examination, localized tenderness in right upper quadrant on deep palpation is observed. A slight yellowish discoloration of skin is noted as well. USG examination reveals the following findings. If this patient had associated gallstones, which of the following would it be?

A 30-year-old patient complains of pain abdomen for 5 days, with similar history in recent past as well. On examination, localized tenderness in right upper quadrant on deep palpation is observed. A slight yellowish discoloration of skin is noted as well. USG examination reveals the following findings. If this patient had associated gallstones, which of the following would it be?

Gallstones are not associated with above clinical scenario.

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Cholesterol stone Pigment stone Mixed stone The USG shows BILIARY ASCARIASIS which is associated with pigment gall stones. Unconjugated bilirubin is normally a minor component of bile, but it will increase when infection of the biliary tract occurs that leads to release of microbial b-glucuronidases, which hydrolyze bilirubin glucuronides. Thus, infection of the biliary tract with Ascaris lumbricoides, and others that increases the likelihood of pigment stone formation.

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