Une cholécystite lithiasique ectopique avec hernie de la ligne blanche: association rare révélée par inflammation pariétale abdominale

Abstract

Conventional treatment of lithiasis of the main biliary tract (MBT) is based on endoscopic sphincterotomy followed by extraction of the stone(s) using a balloon catheter and/or Dormia catheter. Several risk factors associated with failure to remove a stone in the main biliary tract have been reported. The most important factor is probably a stone volume greater than 15 mm or an initial diameter of the MBT smaller than that of the stone. Care must be taken not to impact the stone in the Oddi sphincter or in the Dormia in order not to compromise stone removal. Complications associated with the use of the Dormia catheter include bile duct injuries, which are a well-known surgical problem. Injuries specifically related to the use of catheter have been less reported and seem to be underestimated. We here display an image showing Dormia catheter trapped in the bile duct around a fixed stone which couldn´t be removed after endoscopic exploration in a 60-year-old patient with cholangitis caused by lithiasis. Choledochotomy for removal of stone was performed.