Examination: Jaundice

Jaundice is rarely found on examination and reflects either more chronic obstruction with delayed onset of inflammation, chronic intravascular haemolysis or the development of the classic Charcot triad [5].

If the bile duct does become completely or partially obstructed, the patient will also develop pale stools and dark urine (since bilirubin can no longer pass into the gut in the normal way). The offending stone will usually be found in the common bile duct, but can be found in the neck of the gall bladder or the cystic duct, where it can compress the common hepatic duct causing blockage of bilirubin passage into the gut (Mirizzi's syndrome) [9].