A 6-year-old Girl with Cholecystitis, a Calcium Carbonate Gallstone, and Limy Bile

Abstract

A 6-year-old girl was admitted with upper abdominal pain to her local hospital. She was referred to our hospital because abdominal computed tomography (CT) and magnetic resonance cholangiopancreatography (MRCP) showed cholelithiasis. Limy bile was suspected because the X-ray and CT showed a floating calcified shadow in the right upper abdominal region. On blood tests, hepatobiliary enzyme and CRP levels were within normal ranges. Her pain was easily relieved by an analgesic. ERCP under general anesthesia showed that there was no pancreaticobiliary maljunction, and there was low conjunction of the cystic duct with the common bile duct. There was a cystic duct stone that could not be moved with a guide wire. An attack of biliary colic caused by limy bile and cholecystitis was diagnosed, and laparoscopic cholecystectomy was performed. The neck of the gallbladder had severe inflammation, a finding of chronic cholecystitis. She was discharged on the 4th postoperative day. Limy bile is rare in a child. Thus, this case is reported along with a review of the literature.