Biliary Microlithiasis

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Biliary Microlithiasis - Primary Biliary Cirrhosis

We question a role for foci in primary biliary cirrhosis which improves on URSO therapy. Foci may result in a chronic low grade ampullary obstruction over very long periods. Two patients with elevated liver enzymes had a history of intermittent RUQ pain for up to 18 years. URSO was given with no foci seen on rotational ultrasound. The elevated liver enzymes decreased by 50% but not to normal. The recurrent RUQ pain resolved. Could very low grade elevated CBD pressures over very long periods of time could damage liver parenchyma.