Korean Journal of Gastrointestinal Endoscopy 2001;22(6): 449-453.
종양과의 감별이 어려웠던 원위부 총담관의 감돈 결석 ( An Impacted Distal Common Bile Duct Stone Mimicking a Tumor : An Unusual Manifestation of Gallstone Disease )
정준표(Jun Pyo Chung),김수영(Soo Young Kim),이정일(Jung Il Lee),이세준(Se Joon Lee),문병수(Byung Soo Moon),이관식(Kwan Sik Lee),정재복(Jae Bock Chung),이상인(Sang In Lee),강진경(Jin Kyung Kang),김기황(Ki Whang Kim),지훈상(Hoon Sang Chi),노태웅(Tae Woong Noh)
Abstract
Patients with bile duct stones usually present with biliary pain, obstructive jaundice, ascending cholangitis, or pancreatitis, When endoscopic retrograde cholangiopancreatography (ERCP) is performed, bile duct stones are usually movable and thus easily detected. If a stone in the bile duct presents unusually, it may pose some diagnostic challenges. Recently, we experienced a case of an impacted distal common bile duct (CBD) stone mimicking a tumor which resulted in performing a pylorus-preserving pancreaticoduodenectomy in an asymptomatic 56-year-old man. On ERCP, an obstructing distal CBD lesion did not move even by doing brush cytology. Moreover, the result of brush cytology was positive for atypical cells. A major resective surgery performed after recovery from severe post-ERCP pancreatitis confirmed the diagnosis. Interestingly, this stone caused erosion with acute and chronic inflammation and fibrosis containing foci of mild epithelial dysplasia. We herein report an unusual manifestation of gallstone disease with a review of the literature. (Korean J Gastrointest Endosc 2001;22:449-453)
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