A 92-year-old man had a right hepatectomy and reconstruction of the bile duct due to bile duct cancer 20 years prior. He was admitted due to a fever of 2 days duration and hepatic dysfunction. Abdominal contrast-enhanced computed tomography (CT) and drip infusion cholecystocholangiography (DIC)-CT showed a large enterolith at the reconstructed jejunum limb. We diagnosed cholangitis caused by the enterolith, and conservative therapy was instituted. Due to recurrence of the cholangitis, an enterolithotomy was performed. An enterolith measuring 4.5 cm in diameter was removed. A drainage catheter was placed at the right lateral jejunum limb. The patient's postoperative course was uneventful. This rare case of a large enterolith formed after reconstruction of the bile duct and a discussion of the relevant literature are presented.
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