A Bile Duct Stone Formation around a Fish Bone as a Nidus after Pancreatoduodenectomy

Sakakida, Tomoki; Sato, Hideki; Doi, Takehiko; Kawakami, Takumi; Nakatsugawa, Yoshikazu; Nakamura, Ken; Yamada, Shinya; Fujii, Hideki; Tomatsuri, Naoya; Okuyama, Yûsuke; Kimura, Hiroyuki; Yoshida, Norimasa

doi:10.1159/000486191

Cited by 10 publications

(12 citation statements)

References 12 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Intrabiliary migration of foreign bodies is a rare complication and the literature only consists of case reports. Besides surgical clips, nonabsorbable sutures, coils for arterial embolization, ingested fish bones and toothpicks, and remnants of draining tubes or stents have been reported to migrate into the biliary tract [6, 7, 8]. A literature review of 69 cases of intrabiliary migrated surgical clips showed ERCP to be the appropriate treatment, with a success rate of 85% [9].…”

Section: Discussionmentioning

confidence: 99%

Intrabiliary Migrated Clips and Coils as a Nidus for Biliary Stone Formation: A Rare Complication following Laparoscopic Cholecystectomy

Schreuder

Gulik

Rauws

2018

Case Rep Gastroenterol

View full text Add to dashboard Cite

Clips inserted during laparoscopic cholecystectomy (LC) may migrate into the biliary system and function as a nidus for the formation of gallstones. Here, we present a series of 4 patients who presented with this rare complication 5–17 years after LC. All 4 patients presented with symptomatic choledocholithiasis with biochemical and radiological signs of biliary obstruction. Three patients also had fever and infectious parameters, compatible with concurrent cholangitis. All patients successfully underwent endoscopic retrograde cholangiopancreatography (ERCP) with papillotomy and stone extraction. Patients with cholangitis also had antibiotic treatment. In 3 patients, obstruction of the common bile duct was caused by a single, relatively large stone that had formed around a clip (supposedly the cystic duct clip). In 1 patient, multiple stones had formed around an intrabiliary migrated cluster of coils that had been used for arterial embolization of a pseudo-aneurysm of the right hepatic artery. In conclusion, surgical clips and coils can migrate into the biliary tract and serve as a nidus for the formation of bile duct stones. Although rare, this complication should caution surgeons not to place clips “at random” during cholecystectomy. Patients with this rare complication are best managed by ERCP in combination with sphincterotomy and stone extraction.

show abstract

Section: Discussionmentioning

confidence: 99%

Intrabiliary Migrated Clips and Coils as a Nidus for Biliary Stone Formation: A Rare Complication following Laparoscopic Cholecystectomy

Schreuder

Gulik

Rauws

2018

Case Rep Gastroenterol

View full text Add to dashboard Cite

show abstract

“…In the world, foreign bodies introduced by ingestion have included toothpicks [ 1 , 2 ], needles [ 3 ], fish bones [ 4 , 5 ], chicken bones [ 6 ], and plant fibers [ 7 , 8 ]. Due to the high fish consumption in Japan, a fish bone was the most identified foreign body in the CBD in 16 cases, including our case [ 4 , 9 – 19 ], and plant fiber in one cases [ 20 ] (Table 1 ).…”

Section: Discussionmentioning

confidence: 99%

“…Subsequently, a CBD stone gradually grew around the fish bone and finally became incarcerated for approximately 2 years, causing acute cholangitis. Prior studies have shown the potential for food-based foreign bodies in the CBD to act as a nidus for stone formation, making excretion difficult [ 1 , 9 ]. In our case, the stone that formed around the fish bone was formed of ocher bilirubinate.…”

Section: Discussionmentioning

confidence: 99%

“…In various reports, CT imaging has been useful to identify aspirated fish bones [ 9 , 12 , 28 ]. In our case, the fish bone in the CBD was visible on coronal plane MPR CT images performed at the onset of the cholangitis.…”

Section: Discussionmentioning

confidence: 99%

“…Although endoscopic treatment is currently a well-established procedure, the patient would more likely be treated initially by single- or double-balloon endoscopy [ 9 , 12 ]. However, this would have been technically difficult to perform in our case due to the altered anatomy following the Roux-en-Y reconstruction.…”

Section: Discussionmentioning

confidence: 99%

See 2 more Smart Citations

A case of a common bile duct stone that formed around a fish bone as a nidus after distal gastrectomy with Roux-en-Y reconstruction

2021

View full text Add to dashboard Cite

Background The presence of a foreign body in the common bile duct (CBD) is a rare phenomenon. Thus, the route and mechanism of its migration remain difficult to fully clarify, especially for cases that occur after gastrectomy with Roux-en-Y reconstruction. Herein, we present a case of a CBD stone that formed around a fish bone as a nidus subsequent to distal gastrectomy with Roux-en-Y reconstruction. Case presentation A 70-year-old man was admitted to our hospital due to repeated episodes of epigastralgia. He had undergone distal gastrectomy with Roux-en-Y reconstruction for gastric cancer approximately 10 years prior. Blood tests revealed obstructive jaundice, hepatobiliary dysfunction, and inflammation. Multi-plane reconstructed computed tomography (CT) revealed a CBD stone with a needle-shaped calcification density at the center, oriented along the length of the CBD. Surgery was performed using an upper median laparotomy approach. Lithotomy with choledochotomy was performed to remove one fragile bilirubin stone that had formed around a 3-cm, needle-shaped fish bone. A choledochoduodenal fistula was not detected intraoperatively. A review of the imaging of a prior examination revealed that the formation of the CBD stone around the fish bone was observable on a follow-up CT performed approximately 2 years prior. However, no clinical symptoms associated with the migration of the fish bone to the CBD were reported and the fish bone was not detected at that time. Conclusion In this case, transpapillary migration of the fish bone could only be speculated in the absence of an observable fistula, choledochostomy, or any clinical symptoms. Our case is clinically relevant as cholangitis developed after CBD stone formation around the fish bone that acted as a nidus.

show abstract

Common bile duct obstruction caused by synthetic linear foreign material in a canine dachshund

Zurbuchen,

Stone,

Chambers

et al. 2024

Vet Record Case Reports

View full text Add to dashboard Cite

A 1‐year‐old, female, spayed dachshund presenting with clinical signs associated with cholangiohepatitis and cholangitis was found to have synthetic linear foreign material causing a common bile duct obstruction. The patient underwent a cholecystectomy, and foreign material was removed from the common bile duct via retrograde flushing into the duodenal papilla and manual retrieval. At the 6‐month post‐operative follow up visit, the patient had an improved cholestatic hepatopathy, with only a mild alkaline phosphatase elevation, moderate dilation of the common bile duct on ultrasonography, and was doing clinically well at home. 8 months post‐operatively, the patient re‐presented for an episode of septic cholangiohepatitis, with linear foreign material visualised within a dilated common bile duct on ultrasound. This episode was medically managed and was resolved with a 2‐week course of antibiotics. 1.5 years post‐operatively, the patient is doing clinically well, but continues to have persistent, moderate elevations of alanine transaminase and alkaline phosphatase.

show abstract

A Bile Duct Stone Formation around a Fish Bone as a Nidus after Pancreatoduodenectomy

Cited by 10 publications

References 12 publications

Intrabiliary Migrated Clips and Coils as a Nidus for Biliary Stone Formation: A Rare Complication following Laparoscopic Cholecystectomy

Intrabiliary Migrated Clips and Coils as a Nidus for Biliary Stone Formation: A Rare Complication following Laparoscopic Cholecystectomy

A case of a common bile duct stone that formed around a fish bone as a nidus after distal gastrectomy with Roux-en-Y reconstruction

Common bile duct obstruction caused by synthetic linear foreign material in a canine dachshund

Contact Info

Product

Resources

About