11/25. Duodenal pseudotumour: a silent impacted common bile duct calculus.We report the case of a man with mild dyspeptic symptoms referred for barium meal, who was initially thought to have a duodenal tumour. Subsequent investigation showed this to be a pseudotumour caused by impaction of a gallstone in the distal common bile duct, and endoscopic sphincterotomy effected a cure. This readily treatable condition should be remembered when filling defects are demonstrated in the duodenal loop.- - - - - - - - - - ranking = 1keywords = calculus (Clic here for more details about this article) |
12/25. A thread as a nidus of a common bile duct calculus--findings during endoscopic lithotripsy.Suture material can serve as a nidus for common bile duct calculi. We saw an unusually long thread projecting from a mixed common duct stone in a woman 30 years after cholecystectomy. The calculus was removed endoscopically after mechanical lithotripsy. The implications of this observation, in particular as a potential complication, are discussed.- - - - - - - - - - ranking = 1.25keywords = calculus (Clic here for more details about this article) |
13/25. Bypass of obstructing bile duct calculus by an endoprosthesis inserted via a T-tube track.A surgically introduced biliary endoprosthesis in a patient with a cholangiocarcinoma prevented extraction of a calculus in the lower common bile duct through a T-tube track. The problem was solved by the introduction of a second endoprosthesis across the ampulla of vater through the T-tube track in order to prevent obstruction of the common bile duct by the calculus.- - - - - - - - - - ranking = 1.5keywords = calculus (Clic here for more details about this article) |
14/25. Ultrasonic demonstration of a common bile duct calculus associated with congenital bile duct dilatation.A 8-year-old Japanese girl had congenital bile duct dilatation, associated with both choledocholithiasis and acute pancreatitis. ultrasonography (US) was used to demonstrate a stone within a dilated common bile duct, and US provides the most useful preoperative information to proceed to surgery.- - - - - - - - - - ranking = 1keywords = calculus (Clic here for more details about this article) |
15/25. Pseudocalculus of the common bile duct.Common-bile-duct growths are rarely identified unless they cause chronic biliary obstruction. This case report describes a 71-year-old woman who had jaundice and epigastric pain. A cholecysto-colonic fistula was demonstrated by endoscopic retrograde cholangiopancreatography. The patient also had multiple filling defects in the common bile duct. The fistula was closed and stones were removed. A postoperative cholangiogram showed two calculi. One was removed with a basket through the T-tube tract, but the second, which did not appear completely free of the common-duct wall, could not be removed by the basket method. Subsequently at laparotomy this was found to be a benign pedunculated polyp, composed of collagenous and vascular tissue and with no surface epithelium. Surgeons should bear in mind the possibility of a common-bile-duct growth in cases of extrahepatic biliary obstruction.- - - - - - - - - - ranking = 1keywords = calculus (Clic here for more details about this article) |
16/25. Transcholecystic endoscopic choledocholithotripsy: successful management of retained common bile duct stone.Removal of large common bile duct stones has been a continuing challenge. The feasibility and efficacy of transcholecystic endoscopic choledocholithotripsy in a high-risk patient are demonstrated in this report. The procedure requires an established cholecystostomy track, catheter dilatation of the cystic duct, and the application of electrohydraulic shock waves to the calculus. The use of a choledochofiberscope permits the passage of the electrohydraulic probe and minimizes complications by direct monitoring. Stone fragments are removed by basket retrieval. This procedure in conjunction with minicholecystostomy may obviate the need for surgery in selected high-risk patients with combined gallbladder and common bile duct stones.- - - - - - - - - - ranking = 0.25keywords = calculus (Clic here for more details about this article) |
17/25. Choledochal obstruction by cystic duct stone. Mirizzi's syndrome.Two patients with high-grade common bile duct obstruction from an impacted cystic duct stone are described. A low-lying cystic-choledochal duct juncture or contiguity of a large cystic duct with the common hepatic duct are usual preexisting anatomic conditions. Known as Mirizzi's syndrome, this uncommon phenomenon needs to be considered when clinical and intraoperative findings indicate obstruction of the common bile duct by stone, but bidirectional exploration of the common bile duct or location of an elusive calculus after choledochotomy proves unexpectedly difficult.- - - - - - - - - - ranking = 0.25keywords = calculus (Clic here for more details about this article) |
18/25. edema of the papilla of Vater simulating retained common duct stone.A prominent or edematous papilla of Vater may prodce a rounded filling defect in the duodenum. During T tube or operative cholangiography, this may simulate a calculus impacted in the distal or intramural portion of the common bile duct. This communication reports such an occurrence. Recognition of this potential cause for a false positive cholangiogram should prevent some instances of unnecessary instrumentation of the common bile duct.- - - - - - - - - - ranking = 0.25keywords = calculus (Clic here for more details about this article) |
19/25. cholelithiasis with common bile duct obstruction in a 20-week-old infant.Formation of bile calculi in the common bile duct is a rare event in early infancy. The following article describes the case of a 20-week-old infant with anal atresia and a deep rectovaginal fistula who presented with recurrent jaundice due to a single calculus in the common bile duct that led to intermittent obstruction of the papilla Vateri. diagnosis was proven by endoscopically performed retrograde cholangiography and the concretion was successfully removed after transduodenal papillotomy using a Dormia basket.- - - - - - - - - - ranking = 0.25keywords = calculus (Clic here for more details about this article) |
20/25. An autopsy case of pseudosarcoma of the common bile duct.An autopsy case of pseudosarcoma in the common bile duct is reported. An 82-year-old Japanese male complaining of jaundice was admitted to our hospital; he was examined by abdominal ultrasonography (US), revealing biliary calculus, dilatation of the common bile duct, and choledocholithiasis, considered to be the possible cause of the obstructive jaundice. Endoscopic retrograde biliary drainage (ERBD) and cholangioscopy were performed concurrently, revealing a vaguely whitish tumor near the papilla of Vater. Two months later, the patient died from complications of the liver, infection, and disseminated intravascular coagulation (DIC). An autopsy study revealed tumor cells with extreme pleomorphic changes, growing diffusely, very like sarcoma. Further examination revealed epithelioid arrangements in the metastatic lymph node. Twelve kinds of immunohistochemical examination showed a positive reaction, reflecting the presence of an epithelioid cytoskeleton. Of 28 cases of true and pseudosarcoma of the biliary system reported in the Japanese literature, only 1 case was reported, in 1990, to involve the common bile duct. We therefore report the present case of pseudosarcoma of the common bile duct.- - - - - - - - - - ranking = 0.25keywords = calculus (Clic here for more details about this article) |
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