2021 Volume 63 Issue 3 Pages 293-299
The patient was a 48-year-old man who had undergone distal gastrectomy due to a duodenal ulcer when he was 19 years old. He also underwent choledochojejunostomy at that time because of bile duct injury during the gastrectomy. In 2019, he presented with fever and abdominal pain. Since computed tomography showed many stones in the intrahepatic bile ducts, he was diagnosed as having acute cholangitis. Although we tried to perform endoscopic retrograde cholangiography using balloon-assisted enteroscopy, the upper endoscope could not reach the anastomosis. We performed endoscopic ultrasound-guided hepaticogastrostomy (EUS-HGS) and deployed a plastic stent. After the intervention, all stones spontaneously migrated to the intestine via the widely patent surgical anastomosis.
Here, we report a rare patient who had a history of choledochojejunostomy in which the intrahepatic stones spontaneously migrated to the intestine after performing EUS-HGS.
