case_images: PMC4795881_01
case_images: Case 1: A. Magnetic rResonance cholangiopancreatography (T2). The white arrows indicate bile duct stones in the hilum. B. Bile duct stone formed around a Prolene suture. The black arrows indicate the Prolene suture within the stone. C. Pathological examination of the biliary anastomotic tissue.
case_images: PJMS-32-263-g001.jpg
case_images: PMC4795881_01_PJMS-32-263-g001.jpg
case_images: F1
case_images: Magnetic resonance cholangiopancreatography (MRCP) showed the common bile duct was indistinguishable, with multiple nodular low signals in the hilar bile duct, and the intrahepatic bile duct was dilated (Fig.1A). The stones were formed around sutures (Fig.1B), which was identified as a Prolene suture under macroscopic examination. Pathological examination revealed chronic cholecystitis on mucosal tissue with erosions, hyperplasia of fibrous connective tissue and congestion of the blood vessels in the anastomotic tissue (Fig.1C).
case_images: PMC4795881_02
case_images: Case 2: A. CT scan, showing dilation of the intrahepatic bile duct (black arrows). B. The stone was found after the anastomosis (black arrow) was opened. C. Several bile duct stonesformed around the Prolene sutures. The black arrows indicate the Prolene sutures.
case_images: PJMS-32-263-g002.jpg
case_images: PMC4795881_02_PJMS-32-263-g002.jpg
case_images: F2
case_images: Computed tomography (CT) showed the intrahepatic bile duct was dilated (Fig.2A). Following radical laparocolectomy, we opened the bilioenteric anastomosis, and found there were several bile duct stones that had formed around a suture in the enteric end (Fig.2B). On macroscopic examination, the suture was identified as a Prolene suture, which might have been used for overhanging the bile duct wall left in the lumen (Fig.2C).