PMC117132_01
Large obstructing gallstone just beyond the duodenal bulb with ulcerated duodenal wall.
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F1
In the duodenum just beyond the bulb, very large gallstone was obstructing the lumen measuring about 4 cm x 2 cm (Figure 1).
4 cm mass within the duodenum (gallstone) and adjacent gallbladder with air fluid level.
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F2
The gallbladder was adjacent to the mass and contained an air fluid level (Figure 2).
Gallstone in the duodenum with holes and partial fragmentation after two sessions of laser lithotripsy.
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F3
Two sets of endoscopic therapy with laser application resulted in partial fragmentation of the gallstone, but it still could not be retrieved from the duodenum (Figure 3).
Gallstone in the distal ileum with air in the center and partial destruction of the stone shell.
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F4
A repeat computed tomography showed the gallstone in the distal ileum (Figure 4).