The echoendoscope is in the second portion of the duodenum. We are looking at the common bile duct. We can see that the common bile duct is slightly dilated and there are two hyperechoic foci with shadowing. These findings are consistent with common bile duct stones. Endoscopic ultrasound is very sensitive for the detection of common bile duct stones.
Brenna C. Bounds, M.D., Harvard Medical School, Massachusetts General Hospital