PMC7481483_01
Coronal enhanced CT scan exhibiting a linear metallic density in the CBD consistent with a surgical endoclip.
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A computed tomographic (CT) scan of the abdomen demonstrated a moderately dilated CBD (9 mm), containing a new metallic density when compared to a previous CT scan 14 months earlier (Fig. 1), whereas the number of surgical endoclips at the hepatic hilum has decreased from three to two (Fig. 2a, b).
ERCP showing the clip/stone adjacent to the head of the endoscope in the duodenum, following successful extraction.
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Urgent ERCP revealed a solitary mid-CBD filling defect encasing a linear metallic radiodensity consistent with a gallstone and embedded endoclip (Fig. 3).
ERCP showing the stone in the duodenum after extraction.
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Medium-sized sphincterotomy was successfully performed, and the stone and clip were extracted using a retrieval balloon catheter (Extractor  Pro RX, Boston Scientific, Cork, Ireland) and released into the duodenum (Fig. 4).