Abstract
Limy bile is a relatively rare disease. Though a profound interest has been arisen, its etiology has not been completely identified as yet. This paper presents a case of this disease recently encountered, together with a review of the literature.
A 44-year-old woman was admitted to our hospital with the chief complaints of epigastralgia and low back pain. Plain X-ray film of the abdomen revealed a high density shadow consistently in the area of the gallbladder, which appeared as if examined by cholecystography. The shape of the shadow was transformed by the change of body position. There was a stone shadow of adzuki bean size in the neck. CT disclosed a homogenous high density area within the gallbladder. Cholecystectomy was performed under the diagnosis of limy bile with cholecytolithiasis. The limy bile embeded 7 stones of adzuki bean size and obstructed the cystic duct. Analysis of limy bile by spectrophotometric methods revealed 53% of calcium carbonate. Histological diagnosis of the gallbladder was chronic cholecystitis. Postoperative condition wa satisfactory.
Because this disease manifests characteristic findings in plain X-ray film of the abdomen and CT, the diagnosis may be facilitated, if these characteristics are kept in mind. Lmy bile is surgically curable by cholecystectomy, accordingly early resection of the gallbladder is desirable.
