PMC5516759_01
Impacted gallstone in duodenum.
CRIGM2017-6918905.001.jpg
PMC5516759_01_CRIGM2017-6918905.001.jpg
fig1
An esophagogastroduodenoscopy (EDG) was performed revealing a large duodenal bulb ulcer with a stone lodged in it (Figure 1).
Choledochoduodenal fistula at the base of ulcer.
CRIGM2017-6918905.002.jpg
PMC5516759_01_CRIGM2017-6918905.002.jpg
fig2
The ulcer was 1.5 x 0.5 cm and the suspected choledochoduodenal fistula was identified (Figure 2).
Stone in lithotripter.
CRIGM2017-6918905.003.jpg
PMC5516759_01_CRIGM2017-6918905.003.jpg
fig3
Thus, it was mechanically crushed into 2 pieces using a biliary mechanical lithotripter and extracted (Figure 3).
Broken gallstone.
CRIGM2017-6918905.004.jpg
PMC5516759_01_CRIGM2017-6918905.004.jpg
fig4
The stone measured 2.5 x 3 cm in diameter (Figure 4).