Year 2011 / Volume 103 / Number 1
Digestive Diseases Image
Obstructive jaundice for biliary mold due to foreign body

pp. 36-37

M. Martos, A. Cosme, L. Bujanda, F. Múgica, L. Martín y A. Iribarre

Abstract
vomiting and fever of 38.5 o C, for one month of evolution. She reported a history of cholecystectomy because of multiple cholelithiasis and choledochotomy for removal of intracoledocal stones 24 years ago. The bile duct was closed on nylon tubing Kher 4 / 0 non-absorbable. Among the analytical data stood out: bilirubin, 3.9 mg / dl; ALP, 525 U / L (40-129); GGTP, 1313 U / L (8-61); GOT, 377 U / L (6-38); GPT, 909 U / L (6-41); lipase, 95 U / L (0-60) and ESR, 53 mm / h.
An abdomen ultrasound showed moderate dilatation of the main bile duct. Cholangiography was performed which re- vealed a common bile duct 13 mm in diameter with a tubular image of 30 x 5 mm inside that has a hyperintense core and leaving no acoustic shadow (Fig. 1). ERCP was made that aimed an intracoledocal filling defect of 30 x 5 mm (Fig. 2). Af- ter sphincterotomy, we passed the Fogarty ball and extracted several microstones. Then the cystic duct was channeled and passed the ball again without obtaining material. For the second time, the bile duct was cannulated and introduced the Dormia basket. An elongate, oblong, 3 cm in length biliary mold was extracted (Fig. 3). The pathology report correspond- ed to the suture with biliary debris.
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M. Martos, A. Cosme, L. Bujanda, F. Múgica, L. Martín y A. Iribarre. Obstructive jaundice for biliary mold due to foreign body . 36-37


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