Location

• Hepatopancreatic ampulla

Presentation

• Presentation
• Centralized Back Pain OR Epigastric pain Abdominal Pain
  • Worsened by Alcohol (RF) or Food
  • Alleviated by leaning forward
• +/- N/V - Nausea/vomitting
• Abdominal distension
• Jaundice (if the stone is stuck in the distal CBD)

Investigation

• Obstruction:
  • US → MRCP
• Pancreatitis:
  • Lipase (can order Amylase, but don’t do both)

Treatment

• Obstruction:
  • ERCP
• Pancreatitis
  • Treatment