Acute obstructive cholangitis due to fishbone in the common bile duct: a case report and review of the literature

Abstract

BackgroundCholedocholithiasis is an endemic condition in the world. Although rare, foreign body migration with biliary complications needs to be considered in the differential diagnosis for patients presenting with typical symptoms even many years after cholecystectomy, EPCP, war-wound, foreign body ingestion or any other particular history before. It is of great clinical value as the present review may offer some help when dealing with choledocholithiasis caused by foreign bodies.Case presentationWe reported a case of choledocholithiasis caused by fishbone from choledochoduodenal anastomosis regurgitation. Moreover, we showed up all the instances of choledocholithiasis caused by foreign bodies published until June 2018 and wrote the world’s first literature review of foreign bodies in the bile duct of 144 cases. The findings from this case suggest that the migration of fishbone can cause various consequences, one of these, as we reported here, is as a core of gallstone and a cause of choledocholithiasis.ConclusionThe literature review declared the choledocholithiasis caused by foreign bodies prefer the wrinkly and mainly comes from three parts: postoperative complications, foreign body ingestion, and post-war complications such as bullet injury and shrapnel wound. The Jonckheere-Terpstra test indicated the ERCP was currently the treatment of choice. It is a very singular case of choledocholithiasis caused by fishbone, and the present review is the first one concerning choledocholithiasis caused by foreign bodies all over the world.

A red herring: An unusual case of pneumothorax

“…Fishbone ingestions generally do not result in serious injuries, although sporadic cases have appeared in the literature. [1][2][3] The case presented here shows how a common chief complaint of chest pain could easily be attributed to a pleural effusion or pneumothorax, but was actually secondary to ingesting a fishbone. Additionally, this case illustrates how an initial radiograph may fail to detect needle-like foreign bodies such as an ingested fishbone.…”

Migration of bird feather into bile duct mimicking bile duct stone recurrence: First‐ever case report

“…Left untreated, a foreign body could cause long-term problems or complications, such as pancreatitis, recurrence of cholesterol stones, bile leak, subhepatic abscess, and even death. 1 Bird feathers are often long-stemmed with a pointed tip. The sharp tip of a feather poses an F I G U R E 3 A yellow dart-shaped object was pulled from the bile duct F I G U R E 4 A bird feather with a pinpoint tip, measuring about 5 cm in length even higher risk of causing serious problems if left inside the human body.…”

“…Migration of foreign bodies into the bile duct is rarely reported in the literature 1 . It can cause acute and chronic complications 2 .…”

Fishbone foreign body ingestion in duodenal papilla: a cause of abdominal pain resembling gastric ulcer

“…In addition, at the acute stage, some foreign bodies might be misdiagnosed as choledocholithiasis [6]. At the chronic stage, some foreign bodies might form biliary stones, which may cause the cholangitis [11] or cholecystitis [12]. Moreover, the foreign body may also cause chronic pancreatitis [13].…”