A 9-Year Retained T-Tube Fragment Encased within a Stone as a Rare Cause of Jaundice

Zusammenfassung

Biliäre Komplikationen wie Cholangitis können zu Ikterus und hepatischen Funktionseinschränkung führen. Wir berichten über einen seltenen Fall des Ikterus bei einem 84-jährigen Mann, der sich vor 9 Jahren einer Cholezystektomie unterzogen hat. Die initiale Ultraschalluntersuchung zeigte eine zunächst unklare Cholestase. Die nachfolgende ERCP konnte ein großes Konkrement im Gallengang nachweisen, das sich um ein vor 9 Jahren liegen gebliebenen T-Drain gebildet hat. Mithilfe eines Dormiakörbchens konnte der Stein samt T-Drain aus dem Gallengang geborgen werden. Dieser Fall belegt die ausgesprochen lithogene Wirkung von lange im Gallengang verbliebenen Plastikmaterialien.

Abstract

Biliary diseases such as cholangitis may cause jaundice and liver damage. Here, we report on an unusual cause of jaundice in an 84-year-old man 9 years after cholecystectomy. Ultrasound analysis revealed unclear extrahepatic cholestasis and subsequent ERCP showed a large biliary stone sourrounding a T-tube fragment that had remained in the common bile duct for more than 9 years after surgery. The tip of the drainage and the stone could be successfully removed using Dormia baskets. This case suggests that plastic material accidentally left in the common bile duct favours the development of large biliary casts when present over long periods of time.

Schlüsselwörter

Ausgussstein - ERCP - Cholezystektomie

Key words

stag horn calculus - ERCP - cholecystectomy

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