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
Tóm tắt
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. 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. 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.
Tài liệu tham khảo
Ban JL, Hirose FM, Benfield JR. Foreign bodies of the biliary tract: report of two patients and a review of the literature. Ann Surg. 1972;176:102–7.
Brunaldi VO, Brunaldi MO, Masagao R, Silva C, Masuda H, Brunaldi JE. Toothpick inside the common bile duct: a case report and literature review. Case Rep Med. 2017;2017:5846290.
Dias R, Dharmaratne P. Ingested foreign body in the common bile duct. J Indian Assoc Pediatr Surg. 2012;17:31–2.
Kaji H, Asano N, Tamura H, Yuh I. Common bile duct stone caused by a fish bone: report of a case. Surg Today. 2004;34:268–71.
Orda R, Leviav A, Ratan I, Stadler J, Wiznitzer T. Common bile duct stone caused by a foreign body. J Clin Gastroenterol. 1986;8:466–8.
Baldota S, Breach C, Murtuza B, el Houcheimi B, Darzi A, Hadjiminas DJ. Chicken bone injury of the common bile duct. J R Soc Med. 2000;93:84.
Lv GY, Qiu W, Yu Y, Li T. Development of hepatolithiasis due to a celery stalk retained within the bile ducts of the liver. Ann R Coll Surg Engl. 2016;98:e77–8.
Prochazka V, Krausova D, Kod’ousek R, Zamecnikova P. Foreign material as a cause of choledocholithiasis. Endoscopy. 1999;31:383–5.
Sakakida T, Sato H, Doi T, Kawakami T, Nakatsugawa Y, Nishimura K, et al. A bile duct stone formation around a fish bone as a nidus after pancreatoduodenectomy. Case Rep Gastroenterol. 2018;12:69–75.
Morimoto Y, Fujita T, Mizuno T, Ito A, Nakano T, Hachisuka T, et al. A case of choledocolithiasis caused by fish bones that served as cores around which gallstones developed. Gastroenterol Endosc. 2018;60:1338–43.
Koga Y, Soyama A, Kitasato A, Takatsuki M, Eguchi S. Fishbone migration in the intrahepatic bile duct after pancreaticoduodenectomy. ACG Case Rep J. 2018;5:e18. https://doi.org/10.14309/crj.2018.18.
Bamba H, Nakata T, Sato Y, Shuhei T, Hiroto I, Takayuki I, et al. A case report of a bile duct stone whose formation was induced by a fish bone after pancreatoduodenectomy. Gastroenterol Endosc. 2017;59:62–7.
Kuga T, Oka K, Inokuchi T, Ueda K, Yano Y, Fujii Y. A case report of the patient with foreign body (fish bone) in the intrahepatic bile duct after pylorus preserved pancreatoduodenectomy. Geka. 2016;78:1123–7.
Hori N, Matsuda T, Katsube R, Jeon U, Lee M, Yasuaki K, et al. A case of a fish bone detected in the upper bile duct after gastrectomy and choledochoduodenostomy. J Jpn Surg Assoc. 2016;77:2033–8.
Yoshida A, Ohba K, Morisaki T, Kenichi T, Naoyuki Y, Ken O, et al. A case of common bile duct stone caused by an ingested fish bone. Gastroenterol Endosc. 2010;52:265–71.
Yoshida A, Fujii T, Shibata N, Fumika O, Akinori M, Masaki T. A case of a fish bone in the common bile duct. Gastroenterol Endosc. 2005;47:2191–6.
Watanabe T, Sukigara M, Shinozuka N, Tatsuo Y, Isamu K, Ryouzo O. A case of stone of the common bile duct caused by an ingested fish bone with an ampulla carcinoma of the Vater. J Jpn Surg Assoc. 1999;60:110–3.
Sakai T, Kihara M, Wagayama H, Atsuya S, Mikio K, Yukihiko T. A case of recurrent choledocholithiasis due to foreign bodies (fish bones) after endoscopic sphincterotomy. J Jpn Soc Gastroenterol. 1997;94:143–7.
Kakiuchi M, Iwai K, Akamine T, Sentou F. A case of common bile duct stone caused by a fish bone. J Clin Surg. 1989;44:1955–7.
Takahashi M, Ishii H, Koizumi M, Susumu S. A case report of stones formation in the common bile duct due to a core of a plant. Jpn Soc Gastroenterol Surg. 1991;24:2433–6.
Carballo Rodriguez L, Ruiz Montesinos I, Jimenez Aguero R, Beguiristain GA. Hepatic abscesses secondary to a foreign body in the common bile duct. Rev Esp Enferm Dig. 2017;109:658.
Kim YH, Kim YJ, Park WK, Lee SK, Kwon JH, Woo SK. Fish bone as a nidus for stone formation in the common bile duct: report of two cases. Korean J Radiol. 2004;5:210–3.
Cetta F, Lombardo F, Rossi S. Large foreign body as a nidus for a common duct stone in a patient without spontaneous biliary enteric fistula or previous abdominal surgery. HPB Surg. 1993;6:235–42.
Eguchi S, Matsuo S, Hidaka M, Azuma T, Yamaguchi S, Kanematsu T. Impaction of a shrapnel splinter in the common bile duct after migrating from the right thoracic cavity: report of a case. Surg Today. 2002;32:383–5.
Wada Y, Sasao W, Oku T. Gastric perforation due to fish bone ingestion: a case report. J Gen Fam Med. 2016;17:315–8.
Tanaka M. Advances in research and clinical practice in motor disorders of the sphincter of Oddi. J Hepatobiliary Pancreat Surg. 2002;9:564–8.
Sakamoto K, Shinagawa Y, Inoue K, Morita A, Urakawa H, Fujimitsu R, et al. Obliteration of the biliary system after administration of an oral contrast medium is probably due to regurgitation: a pitfall on MRCP. Magn Reson Med Sci. 2016;15:137–43.
Venkatesh SH, Venkatanarasimha Karaddi NK. CT findings of accidental fish bone ingestion and its complications. Diagn Interv Radiol. 2016;22:156–60.