Bleeding birth of a gallstone from a hanging papilla of Vater

A case of major gastrointestinal hemorrhage due to the passage of a gallstone from a 20 mm long, hanging papilla of Vater is presented. An upper digestive endoscopy revealed the stone in the very process of expulsion from the papilla into the duodenum in which fresh blood was seen. Bleeding stopped a few days afterwards. Follow-up endoscopic and radiological examinations of the gastrointestinal tract disclosed no other potential source of bleeding.