2022 Volume 64 Issue 2 Pages 172-178
An 86-year-old man was admitted to our hospital with chief complaints of cough and fever. Chest and abdominal CT scans detected pneumonia and a linear high-absorption structure of about 20 mm in length, within the common bile duct. MRI results revealed an elongated abnormality, while endoscopic ultrasonography results confirmed the presence of a hyperechoic structure in the common bile duct. Together, these findings suggested the possibility of the foreign object being a stone that formed around an ingested fish bone. Following pneumonia recovery, the stone was removed using the peroral cholangioscopy (POCS) “mother-baby” scope insertion system. Pathological examination and stone analysis of the foreign body revealed that the core of the bile duct stone was made of plant tissue. Interestingly, this patient had no history of treatment involving the major duodenal papilla. Cases of bile duct stones developing as a result of plant tissue entering an untreated duodenal papilla are rare; hence, we report this case along with a review of the literature.
