Spontaneous Disappearance Of Limy Bile; Report Of A Case With Review Of The Literature
American Journal of Gastroenterology 79(11): Nov 1984; 884-888
View Original Source →Abstract
Spontaneous disappearance of limy bile is extremely rare, and only four cases have so far been reported. This is the account of the fifth case, a 42-year-old woman, who spontaneously lost a stone incarcerated in the neck of the gallbladder and all of the limy bile, after symptoms suggestive of a transient obstructive jaundice. Various investigations including ultrasound, computed tomography, and percutaneous transhepatic cholangiography suggested spontaneous passage of the stone through the cystic duct and the papilla of Vater, followed by limy bile. Apparently the patient’s gallbladder had a contracting capacity. The literature on this subject is briefly reviewed.
Case Details
Personal Characteristics
42-year-old woman
Clinical Characteristics
Epigastric discomfort, deformed duodenal bulk, active ulcer, radiopaque material in the right upper quadrant, visible gallbladder of calcium density, small radiopaque stone shadow, dark urine, mild abdominal pain, nausea, vomiting, slight icterus, right upper quadrant tenderness
Remission Characteristics
Complete evacuation of limy bile from the gallbladder, no trace of the radiopaque material in the gallbladder, no calculus or fistula in the biliary system, disappearance of echogenic material in the gallbladder, no increased densities in the gallbladder
Treatment & Mechanisms
Proposed Remission Mechanisms
Spontaneous passage of the stone through the cystic duct and the papilla of vater
Clinical Treatment
Percutaneous transhepatic cholangiography, ultrasonography, computed tomography
Additional Notes
The patient refused surgery and was followed as an outpatient. She was admitted to the hospital due to obstructive jaundice. She was discharged from the hospital on the 34th hospital day. As of June 1984, she had no evidence of recurrent stone disease or limy bile.