A 73-year-old woman with intermittent fever and abdominal pain was referred to our hospital. Her hepatobiliary system enzymes and inflammatory reaction were elevated, and an enterolith of a juxtapapillary duodenal diverticulum, cholangiectasis were showed on CT scan. On suspicion of Lemmel syndrome, performs emergency ERCP, was placed the ENBD. Cholangitis is gradually improving, and replacing the ENBD to plastic stent on the 19th hospital day. On the 34th hospital day, she developed vomiting and abdominal pain. Although the enterolith of a juxtapapillary duodenal diverticulum was not recognized, the enterolith in the small intestine and small bowel ileus were revealed. Did not improve in the conservative therapy by ileus tube inserted, an enterotomy was performed to remove the enterolith. The enterolith was spherical, 25mm in diameter. On CT scan and in operative findings, there was no traffic in the juxtapapillary duodenal diverticulum to gallbladder and common bile duct. Therefore, the enterolith was thought to have been formed in the juxtapapillary duodenal diverticulum.
