1.Fish Bone as a Nidus for Stone Formation in the Common Bile Duct: Report of Two Cases.
Young Hwan KIM ; Yong Joo KIM ; Won Kyu PARK ; Sang Kwon LEE ; Jung Hyeok KWON ; Seong Ku WOO
Korean Journal of Radiology 2004;5(3):210-213
We report two cases of common bile duct stone formed around a fish bone which migrated from the intestinal tract, along with their characteristic imaging findings. Two patients who had no history of previous operation were admitted because of cholangitis. Percutaneous transhepatic biliary drainage (PTBD) was performed and the cholangiogram showed filling defects with an unusually elongated shape in the common bile duct. After improvement of the cholangitic symptoms, the stones were removed through the PTBD tract under fluoroscopic guidance. A nidus consisting of a 1.5 cm sized fish bone was found in each stone removed.
Aged
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Animals
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Bone and Bones/*radiography/*ultrasonography
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Cholangiography
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Cholangitis/etiology
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Choledocholithiasis/*etiology/surgery
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Female
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Fishes
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Foreign Bodies/*complications/surgery
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Humans
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Male
2.A Case of Common Bile Duct Stone Formed around a Surgical Clip after Laparoscopic Cholecystectomy.
Kyoung Wook LEE ; Jin Woo LEE ; Seok JEONG ; Bong Joo JUNG ; Don Haeng LEE ; Pum Soo KIM ; Hyung Gil KIM ; Young Soo KIM ; Sun Keun CHOI
The Korean Journal of Gastroenterology 2003;42(4):347-350
Laparoscopic cholecystectomy has now rapidly replaced open cholecystectomy. Rarely a calculus may arise from a metallic surgical clip migrated into the common bile duct (CBD) after this surgical procedure was performed. We report a 50-year-old man with CBD stone formed around a surgical clip, who had undergone a laparoscopic cholecystectomy because of acute calculous cholecystitis 14 months before. Abdominal CT revealed a single stone in mildly dilated CBD. A high density core within the CBD stone, was suspected to be a surgical clip. The stone was removed using a retrieval balloon catheter and basket after endoscopic sphincterotomy.
Cholecystectomy, Laparoscopic/adverse effects/*instrumentation
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Choledocholithiasis/*etiology
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*Foreign-Body Migration
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Humans
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Male
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Middle Aged
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Surgical Instruments/*adverse effects
3.Type of Electric Currents Used for Standard Endoscopic Sphincterotomy Does Not Determine the Type of Complications.
Se Joon LEE ; Kee Sup SONG ; Jun Pyo CHUNG ; Dok Yong LEE ; Yon Soo JEONG ; Sang Won JI ; Yong Han PAIK ; Seung Woo PARK ; Si Young SONG ; Kwan Sik LEE ; Jae Bock CHUNG ; Sang In LEE ; Jin Kyung KANG ; Seung Ho CHOI
The Korean Journal of Gastroenterology 2004;43(3):204-210
BACKGROUND/AIMS: The blended current is usually used for endoscopic sphincterotomy (EST) to minimize bleeding. The pure cutting current may induce less edema of the ampulla and therefore result in less injury to the pancreas theoretically. The aim of this study was to evaluate effects of electric currents used on the development of serum pancreatic enzyme evaluation, clinical pancreatitis or bleeding after EST. METHODS: One hundred and eighteen consecutive patients who underwent EST with standard papillotome alone for the treatment of choledocholithiasis were reviewed. All EST had been performed by two endoscopists whose experience on EST was similar: one uses 'blended current' (BC group, n=74), while the other uses 'pure cutting current' (PC group, n=44). RESULTS: Baseline clinical, laboratory, and procedural parameters were similar in both groups. The incidences of hyperamylasemia and hyperlipasemia were similar between two groups. There was no significant difference in the incidence of clinical pancreatitis between two groups (BC 6.8% vs PC 0.0%, p=0.1557). All episodes of pancreatitis were mild. No episodes of significant bleeding occurred after EST. The incidences of sepsis, cholangitis and perforation were also not different between two groups. CONCLUSIONS: Development of complications after standard EST such as hyperamylasemia, clinical pancreatitis, and bleeding may not depend on the electric current used.
Aged
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Choledocholithiasis/surgery
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English Abstract
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Female
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Humans
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Male
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Middle Aged
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Pancreatitis/etiology
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Sphincterotomy, Endoscopic/*adverse effects/methods
4.A Case of Spontaneous Perforation of the Common Bile Duct Associated with Cholangitis.
Byoung Kwan YOO ; Jong Hyeok KIM ; Hong Ju MOON ; Won Seok CHEON ; Ji Youn YOO ; Jong Pyo KIM ; Kyoung Oh KIM ; Cheol Hee PARK ; Tae Ho HAHN ; Kyo Sang YOO ; Sang Hoon PARK ; In Jae LEE ; Choong Kee PARK
The Korean Journal of Gastroenterology 2005;45(5):361-364
Spontaneous perforation of the common bile duct (CBD) is a rare event in adults. Most cases of CBD perforation are iatrogenic after invasive procedures such as endoscopic retrograde cholangiopancreatography (ERCP) or cholecystectomy. We report a case of an 81-year-old woman who presented with severe right upper abdominal pain, fever, and chills. Abdominal CT showed multiple gallbladder and CBD stones and loculated fluid collection in the inferoposterior portion of the stomach. ERCP showed the leakage of contrast media into the peritoneal cavity from the CBD. We performed endoscopic sphincterotomy (EST) and endoscopic nasobiliary drainage (ENBD) to decompress the CBD instead of emergent surgical intervention. One week later, cholangiography via ENBD tube revealed that there was no more leakage of the contrast media from the CBD. We performed cholecystectomy, removal of the CBD stones after exploration of the CBD, and T tube insertion. The perforated site of the CBD was closed and there was no more fluid collection in the inferoposterior portion of the stomach. Medical treatment including endoscopic procedures was useful for healing of the perforated CBD.
Aged, 80 and over
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Cholangiopancreatography, Endoscopic Retrograde
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Cholangitis/*complications
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Choledocholithiasis
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Common Bile Duct Diseases/*etiology
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Female
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Humans
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Rupture, Spontaneous
5.A Case of Common Bile Duct Stone Developed due to a Surgical Clip as a Nidus: An Experience of Successful Management by Endoscopy.
Hyae Ju OH ; Hyo Jin JUNG ; Jong In CHAI ; Weul Yong CHOI ; Kyoung Min KIM ; Jong Han KIM ; Yong Mok BAE ; Jeong Ho HEO
The Korean Journal of Gastroenterology 2003;42(4):351-353
Surgical clips can migrate into the biliary tract and act as a nidus for stone formation. We report a case of common bile duct stone developed due to a surgical clip in a 48-year-old man. Endoscopic retrograde cholangiogram revealed a common bile duct stone a with metallic clip in it. He had laparoscopic cholecystectomy 10 years ago. The stone was removed endoscopically. The use of resorbable clips during laparoscopic cholecystectomy is recommended to avoid this type of complication.
Cholangiopancreatography, Endoscopic Retrograde
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Cholecystectomy, Laparoscopic/adverse effects/*instrumentation
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Choledocholithiasis/*etiology/radiography/therapy
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*Foreign-Body Migration
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Humans
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Male
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Middle Aged
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Surgical Instruments/*adverse effects
6.A Case of Afferent Loop Syndrome with Acute Cholangitis Developed after Percutaneous Transhepatic Cholangioscopic Lithotripsy for Treatment of Choledocholithiasis in a Patient Who Underwent Billroth II Gastrectomy.
Seong Hyun KIM ; Kye Sook KWON ; Seok JEONG ; Don Haeng LEE ; Kyung Sun MIN ; Jin Woo LEE ; Yong Woon SHIN ; Yong Sun JEON
The Korean Journal of Gastroenterology 2012;59(2):180-184
Afferent loop syndrome is a rare complication which can occur in patients with Billroth II gastrectomy. Bile and pancreatic juice is congested at afferent loop in the syndrome. This syndrome can progress rapidly to necrosis, perforation, or severe sepsis, and therefore early diagnosis and swift surgical intervention is important. But, cases of endoscopic or percutaneous transhepatic drainage have been reported when surgical management was inappropriate to proceed. We report a case of afferent loop syndrome accompanying acute cholangitis developed after percutaneous transhepatic cholangioscopic lithotripsy for the retrieval of common bile duct stone in a patient who underwent Billroth II gastrectomy due to early gastric cancer. There was no other organic cause. We treated afferent loop syndrome successfully by performing balloon dilation of afferent loop outlet.
Acute Disease
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Afferent Loop Syndrome/*etiology
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Aged, 80 and over
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Balloon Dilation
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Cholangiography
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Cholangitis/*etiology
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Choledocholithiasis/*diagnosis/radiography/therapy
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Common Bile Duct
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Gallstones/*diagnosis/therapy
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Gastroenterostomy
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Humans
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Lithotripsy/*adverse effects
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Male
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Stomach Neoplasms/surgery
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Tomography, X-Ray Computed