Patient: Description (onset time, main symptoms, hospital visited, etc.): Right hepatic distension and pain in the back and shoulder, ultrasound report “intrahepatic bile duct stones” I would like to know if treatment is needed and how to treat. First of all, ultrasound alone cannot clearly diagnose intrahepatic bile duct stones, especially because ultrasound does not clearly report dilated bile ducts. Rather, the ultrasound presentation of intrahepatic calcified foci is also a strong echogenic mass followed by acoustic shadow. According to your presentation, the strong echogenic mass is only 2mm. We suggest you to check an enhanced CT to see whether it is an intrahepatic calcified foci or intrahepatic bile duct stones. If it is the former, no treatment is needed and there is no relationship between your symptoms and the intrahepatic calcified foci. If intrahepatic bile duct stones are considered, MRCP may also be needed to further clarify the specific information on the extent, distribution and number of stones before a treatment plan can be formulated.