case_images: PMC5530427_01
case_images: Gallstone seen near top of common bile duct.
case_images: CRIS2017-5878614.001.jpg
case_images: PMC5530427_01_CRIS2017-5878614.001.jpg
case_images: fig1
case_images: Dormia basket was left in situ. During repeat ERCP three weeks later the large CBD stone (Figure 1) was engaged in a Dormia basket for mechanical lithotripsy but on cranking the lithotripter handle the wires snapped externally at the mouth (Figure 2).
case_images: Dormia basket in CBD, after handle has broken (endoscope has been removed pending urgent surgery).
case_images: CRIS2017-5878614.002.jpg
case_images: PMC5530427_01_CRIS2017-5878614.002.jpg
case_images: fig2
case_images: Dormia basket was left in situ. During repeat ERCP three weeks later the large CBD stone (Figure 1) was engaged in a Dormia basket for mechanical lithotripsy but on cranking the lithotripter handle the wires snapped externally at the mouth (Figure 2).
case_images: Choledochoscopic view of distal CBD. Large stone is seen within impacted ERCP Dormia basket.
case_images: CRIS2017-5878614.003.jpg
case_images: PMC5530427_01_CRIS2017-5878614.003.jpg
case_images: fig3
case_images: A 5 mm choledochoscope was introduced via a longitudinal choledochotomy and confirmed the presence of an impacted basket plus large stone at the ampulla (Figure 3).
case_images: Debulked ERCP Dormia basket now collapsed and ready for removal, with few remaining stone fragments.
case_images: CRIS2017-5878614.004.jpg
case_images: PMC5530427_01_CRIS2017-5878614.004.jpg
case_images: fig4
case_images: Having debulked the stone load (Figure 4), it was then possible to gently deliver the ERCP Dormia basket back into the duodenum without complication, which could then be removed orally.