Common bile duct stone caused by a fish bone: report of a case

Investigations to determine the cause of jaundice in an 83-year-old man led to the diagnosis of incomplete obstruction of the common bile duct due to stone formation around an ingested fish bone. Abdominal ultrasound and computed tomography performed preoperatively revealed evidence of chronic cholecystitis with a gallstone and calcification in the common bile duct. Endoscopic retrograde choangiopancreatography showed stone formation in the common bile duct. After normalizing the serum bilirubin level by endoscopic retrograde bile duct drainage, we performed cholecystectomy and choledocholithotomy, which revealed stone formation around an ingested bone in the common bile duct. To the best of our knowledge based on a computer-assisted search, this is only the third report of the formation of a choledocal stone around an ingested fish bone. We reviewed the literature on choledocholithiasis caused by a foreign body, in an attempt to classify this entity according to the pathways through which a foreign body can migrate into the common bile duct.