case_images: PMC11362765_01
case_images: CT scan image showing bile duct dilatation with lithiasis.
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case_images: CT scan revealed dilatation of the intrahepatic bile ducts and the common bile duct measuring 12 mm. Cystic duct stump lithiasis was also found [Fig. 1].
case_images: Endoscopic findings showing common bile duct stones and cystic duct stump calculus.
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case_images: ERCP findings showing common bile duct (CBD) dilatation with CBD stones.
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case_images: After the latest investigations, Endoscopic retrograde cholangiopancreatography (ERCP) was performed, showing a dilatation of the common bile duct (CBD) measuring 14 mm upstream of lower bile duct stones [Fig. 3].
case_images: Endoscopic findings of a bulging major duodenal papilla suspicious for intra-ampullary papillary malignancy.
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case_images: A bulging major duodenal papilla was endoscopically evident [Fig. 4], requiring a sphincterotomy margin biopsy with benign results.
case_images: Morphology of Micrococcus lylae on Blood agar culture (A) and in Gram staining under the microscope (B).
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case_images: Microscopic examination of the positive enrichment in the aerobic broth revealed gram- positive cocci arranged in tetrads and irregular clusters [Fig. 5 (B)]. Subsequent subculture on blood agar, incubated for 24 h at 37  C, resulted in the isolation of creamy white convex circular colonies [Fig. 5 (A)] that tested positive for catalase and oxidase.