PMC6444230_01
Abdominal CT showing the surgical clips by the cystic duct from the patient's prior cholecystectomy in 2004 (boxed).
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fig1
There is mild-moderate intrahepatic ductal dilatation." Figures 1 and 2 show images from the CT surgical clips from cholecystectomy by the cystic duct (Figure 1) as well as common bile duct dilation with a hyperdense foreign body by the ampulla of Vater, most likely a migrated surgical clip (Figure 2).
Abdominal CT showing a radiodense foreign body by the ampulla of Vater, most likely a migrated surgical clip from the prior cholecystectomy (arrow).
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fig2
There is mild-moderate intrahepatic ductal dilatation." Figures 1 and 2 show images from the CT surgical clips from cholecystectomy by the cystic duct (Figure 1) as well as common bile duct dilation with a hyperdense foreign body by the ampulla of Vater, most likely a migrated surgical clip (Figure 2).
ERCP showing both the surgical clips by the cystic duct (boxed) as well as a foreign body that looks like a clip by the ampulla of Vater (arrow).
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fig3
Endoscopic retrograde cholangiopancreatography (ERCP) was then performed, which located the surgical clip that migrated distally (Figure 3).
Image taken from ERCP showing a clip with stone attached, coming out of the ampulla of Vater.
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fig4
The clip with a stone attached was then removed via balloon sweep (Figure 4), resulting in subsequent resolution of abdominal pain and normalization of the liver function tests.