Clinically the patient falls under the so-called five F's: fat, female, forty, fertile, and fair. In addition, many other factors lead to the development of gallstones that include pregnancy, diabetes, oral contraceptive use, hemolytic diseases, diet-induced weight loss, and total parenteral nutrition.
Patients may be asymptomatic until a stone lodges in the cystic or common duct. Right-upper-quadrant pain with radiation to the shoulder after a high-fat meal is a typical presentation for cholelithiasis.
Epigastric pain, nausea, and vomiting are present when the symptoms become acute.
Choledochal cysts are an unusual, diverse group of diseases that may manifest as congenital, focal, or diffuse cystic dilatation of the biliary tree. The choledochal cyst may be the result of pancreatic juices refluxing into the bile duct because of an anomalous junction of the pancreatic duct into the distal common bile duct, causing duct wall abnormality, weakness, and outpouching of the ductal walls. These cysts are rare; the incidence is more common in females than males (4 : 1), with an increased incidence in infants (the condition may occur in less than 20% of adults). Choledochal cysts may be associated with gallstones, pancreatitis, or cirrhosis. The patient presents with an abdominal mass, pain, fever, or jaundice. The diagnosis may be confirmed with a nuclear
"Aneurysm of bile duct"