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Cirugía paraguaya
versión On-line ISSN 2307-0420
Resumen
CACERES, Heidi et al. Residual lithiasis versus primary lithiasis bile duct: a controversial case report. Rev. Cir. Parag. [online]. 2013, vol.37, n.1, pp.36-37. ISSN 2307-0420.
Choledocholithiasis is defined as the presence of calculus in the choledocho and it can be, according the site of formation, primary or secondary. Most of them are secondary. The objective of this paper is to present one case of choledocholithiasis many years after cholecystectomy, demonstrating one faceted lithiasis. This is a female patient, 42 years old, with 4-day history of epigastric pain, associated with fatty foods and history of cholecystectomy 11 years ago. Physical examination finds Kocher scar and pain in epigastrium and right hypochondrium. The ultrasonography of the biliary tract shows a dilated common bile duct, with choledocholithiasis in the third distal of conduct. The retrograde cholangiopancreatography confirm the presence of faceted lithiasis. Many years after cholecistectomy is difficult to determi- nate with total security if a lithiasis in the common bile duct is primary or secondary. The criteria to determinate that a choledocholithiasis is primary are not unified.
Palabras clave : Cholelithiasis; Residual lithiasis; Primary lithiasis of the bile duct.