Korean J Radiol.  2004 Sep;5(3):210-213. 10.3348/kjr.2004.5.3.210.

Fish Bone as a Nidus for Stone Formation in the Common Bile Duct: Report of Two Cases

• Kim YH
• Kim YJ
• Park WK
• Lee SK
• Kwon JH
• Woo SK

• KMID: 1118826
• DOI: http://doi.org/10.3348/kjr.2004.5.3.210

Abstract

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.

Keyword

Biliary duct stones; Foreign bodies; Fish bone

MeSH Terms

Aged
Animals
Bone and Bones/*radiography/*ultrasonography
Cholangiography
Cholangitis/etiology
Choledocholithiasis/*etiology/surgery
Female
Fishes
Foreign Bodies/*complications/surgery
Humans
Male

Figure

• 

  Fig. 1 A 75-year-old woman with common bile duct stone. A. Ultrasonography demonstrates a hyperechoic stone with acoustic shadowing (arrow) in the common bile duct. B. Computed tomography shows a common bile duct stone containing a bright dot of bone density (arrow). C. Cholangiogram shows an elongated filling defect in the common bile duct. D. Photograph of specimen extracted from common bile duct using a stone basket shows a friable pigment stone (thick arrow), that was formed around a fish bone (thin arrow).

• 

  Fig. 2 A 67-year-old man with common bile duct stone. A. Cholangiogram shows an elongated filling defect in the common bile duct. B. Photograph of specimen extracted from common bile duct using a stone basket shows a friable pigment stone, that was formed around a fish bone.

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