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December 1999, Vol 134, No. 12 >

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Surgical Reminiscences | December 1999

The Case of the Common Duct Stone:  Cholesterol Revisited

Ralph G. DePalma, MA, MD
Arch Surg. 1999;134(12):1398-1399. doi:10.1001/archsurg.134.12.1398.
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THE CALL from a junior medical resident at Lakeside Hospital in Cleveland, Ohio, was puzzling.

"We have a 55-year-old lady with a serum cholesterol of 600 mg percent because there is a stone blocking her common bile duct!"

"Is she jaundiced?"

"Not at all. The stone is causing cholesterol to back up."

I had learned by the time I was chief resident, in 1964, not to play 20 questions with referring doctors. Stifling incredulity, I replied, "I'll be right there."

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