Abstract
The patient, a 54-year-old woman, was admitted to a nearby doctor with epigastric pain. She was diagnosed with cholecystitis, and referred to our hospital under the diagnosis of acute cholecystitis. Abdominal CT showed high-density nodules in the gallbladder and duodenum. Endoscopic study showed a protruding lesion in the first portion of the duodenum. Endoscopic ultrasonography showed a hyperechoic lesion with an acoustic shadow in the duodenal wall, suggesting an aberrant stone in the duodenal wall. Under the diagnosis of gallstone cholecystitis and stone in the duodenal wall with cholecyst-oduodenal fistula, cholecystectomy and enucleation of the aberrant stone were performed. Operative observations showed no fistula between the gallbladder and duodenum. Postoperative analysis of stone components revealed little difference between the aberrant stone and gallstones. We also thought that the gallstone had passed through the common bile duct and impacted into the duodenal wall, where it became covered by duodenal mucosa. We report herein a quite rare case of aberrant gallstone in the duodenal wall.
