Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
Corresponding author:
Seung Jae Myung,
ABSTRACT
We report a case in which a suture material may serve as a nidus for common bile duct calculi. A 40-year-old woman, 4 years after cholecystectomy and common bile duct exploration, presented right upper quadrant pain and jaundice. Endoscopic retrograde cholangiography revealed filling defect in the distal common bile duct. After endoscopic sphincerotomy, several stones and linear suture material were extracted. Grossly, the stone was shown to be penetrated by the suture material. At electron microscopic examination, calcium bilirubinate granules and cholesterol crystals were attached to the linear strands of the suture material. The implications of this observation, in particular as a potential complication after biliary tract surgery, are discussed.
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