Korean J Gastroenterol.  2016 Mar;67(3):150-152. 10.4166/kjg.2016.67.3.150.

Common Bile Duct Obstruction Due to a Large Stone at the Duodenal Stump

Affiliations
  • 1Department of Internal Medicine, CHA Medical Center, CHA University, Seongnam, Korea.
  • 2Department of Surgery, CHA Medical Center, CHA University, Seongnam, Korea.
  • 3Digestive Disease Center, CHA Medical Center, CHA University, Seongnam, Korea. bluehipp@cha.ac.kr

Abstract

Enterolith is a rare complication of Billroth II gastrectomy. Most enterolith cases have been reported in association with diverticula, tuberculosis, and Crohn's disease. We report the case of a huge enterolith that developed in the duodenal stump following common bile duct obstruction and cholangitis, necessitating surgery. The enterolith was clearly visible on the abdominal computed tomography. It was removed through a duodenotomy. The surgery was successful without any significant complications.

Keyword

Enterolith; Duodenal stump; Cholangitis

MeSH Terms

Abdomen/diagnostic imaging
Aged
Cholestasis/*diagnosis/etiology/surgery
Duodenal Diseases/*diagnosis/etiology/surgery
Female
Gallstones/complications/diagnosis
Gastroenterostomy
Humans
Tomography, X-Ray Computed

Figure

  • Fig. 1. Computed tomography scans of the abdomen. It shows a 4.8 cm sized, large, and calcified stone at a duodenal stump (A; arrow) and a dilated common bile duct, about 1.8 cm in diameter (B; arrow).

  • Fig. 2. Cystic duct and common bile duct were clear, while no visible passage of contrast medium to the duodenum was seen on tubogram.

  • Fig. 3. (A) Under laparoscopy, the duodenal stump was enlarged and filled with a large mass. (B) While gallbladder stones were black, small and multiple (white arrow), the enterolith in the duodenum was about 5 cm-size big brownish stone, which was cru-shed into several pieces for extraction during the operation (black arrow head).


Reference

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