Clinical Presentation

This 57-year-old patient has undergone a liver transplant.

(A) Selected image from a percutaneous cholangiogram. Dual access has been obtained via the right and left ducts. A large filling defect within the common bile duct is consistent with a large biliary stone. The Roux-en-Y bilioenteric anastomosis is patent. (B) Selected image from an over-the-wire cholangiogram obtained during balloon angioplasty of the bilioenteric anastomosis. Angioplasty was performed to allow passage of the stone through the anastomotic site. (C)