Abstract
A 60-year-old woman underwent endoscopic sphincterotomy (EST) for the removal of common bile duct stones (CBDS). Subsequent postoperative abdominal computed tomography scans revealed recurrence of CBDS and the patient was admitted to our hospital for surgery. Although the patient had been vomiting before surgery, no evidence of ileus was found on abdominal plain X-ray imaging. Surgery was therefore performed on the following day. No stone was visually detected in the biliary tract, but intraoperative cholangiography revealed several stones impacted in the horizontal portion of the duodenum. On the basis of this finding, gallstone ileus was diagnosed. It was remarkable that the preoperatively observed CBDS passed through the natural biliary tract and became impacted in the duodenum. Passing of gallstones in this manner is a rare cause of gallstone ileus. The risk of gallstone ileus, however, should be considered following EST, since a large gallstone can readily pass through an incised duodenal papilla.
