A CASE OF COMPLEX DIAGNOSIS OF CHOLEDOCHOLITHIASIS WITH MECHANICAL JAUNDICE
A case of prolonged and complex diagnosis of mechanical jaundice caused by choledocholithiasis in a 32-year-old man is described. Concretions in the common bile duct of the patient with repeated ultrasound in various medical institutions were not detected, which once again indicates that this method is largely operator-dependent. Multispiral computed tomography with intravenous contrast and magnetic resonance cholangiography performed at intervals of 4 days, revealing a concretion of the neck of the gallbladder, did not show signs of choledocholithiasis. Probably, this may be due both to the peculiarities of the chemical composition and density of concretions, and to the adequacy, thoroughness of compliance with the recommended modes of implementation of these research methods. In this case, endoscopic retrograde pancreatocholangiography turned out to be the final method of diagnosing the cause of MJ and, at the same time, the therapeutic method. This partly contradicts the modern attitudes of the majority of experts who consider this method to be quite invasive, risky for diagnosis, and requires further improvement of the algorithm and mode of non-invasive radiation methods of nosological diagnosis of MJ.