An Impacted Distal Common Bile Duct Stone Mimicking a Tumor: An Unusual Manifestation of Gallstone Disease.
- Author:
Jun Pyo CHUNG
1
;
Soo Young KIM
;
Jung Il LEE
;
Se Joon LEE
;
Byung Soo MOON
;
Kwan Sik LEE
;
Jae Bock CHUNG
;
Sang In LEE
;
Jin Kyung KANG
;
Ki Whang KIM
;
Hoon Sang CHI
;
Tae Woong NOH
Author Information
1. Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea. chungjp@yumc.yonsei.ac.kr
- Publication Type:Case Report
- Keywords:
Impacted stone;
Gallstone;
Common bile duct;
Pancreaticoduodenectomy;
Dysplasia
- MeSH:
Bile Ducts;
Cholangiopancreatography, Endoscopic Retrograde;
Cholangitis;
Common Bile Duct*;
Diagnosis;
Fibrosis;
Gallstones*;
Humans;
Inflammation;
Jaundice, Obstructive;
Middle Aged;
Pancreaticoduodenectomy;
Pancreatitis
- From:Korean Journal of Gastrointestinal Endoscopy
2001;22(6):449-453
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
Patients with bile duct stones usually present with biliary pain, obstructive jaundice, ascending cholangitis, or pancreatitis. When endoscopic retrograde cholangiopancreatography (ERCP) is performed, bile duct stones are usually movable and thus easily detected. If a stone in the bile duct presents unusually, it may pose some diagnostic challenges. Recently, we experienced a case of an impacted distal common bile duct (CBD) stone mimicking a tumor which resulted in performing a pylorus-preserving pancreaticoduodenectomy in an asymptomatic 56-year-old man. On ERCP, an obstructing distal CBD lesion did not move even by doing brush cytology. Moreover, the result of brush cytology was positive for atypical cells. A major resective surgery performed after recovery from severe post-ERCP pancreatitis confirmed the diagnosis. Interestingly, this stone caused erosion with acute and chronic inflammation and fibrosis containing foci of mild epithelial dysplasia. We herein report an unusual manifestation of gallstone disease with a review of the literature.
