A surgical thread as a nidus for the common bile duct stone formation

A 68-year old patient, who had had cholecistectomy when he was 30 years old and had been hospitalized in several occasions, with clinical presentation of recidivant cholangitis was admitted to county hospital. Computed tomography was performed, where a bile duct dilatation was noted, with suspected 12 mm concrement. After that the patient was referred to the hospital in order to undergo therapeutic endoscopic retrograde cholangiopancreatography. After performing the procedure, the presence of the concrement, 12x25mm in size was confirmed. It was evacuated during mechanical lithotripsy along with a part of surgical thread, which could not have been extracted entirely. A surgery had to be performed because the patient developed cholestasis. Forming of choledocholith most likely developed on the matrix of surgical thread, which is a rare cause of choledocholithiasis.