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Case report
Endoscopic management of limy bile syndrome presenting with obstructive jaundice
  1. Ahmed Mohammed AlMuhsin,
  2. Ahmad Altaweel and
  3. Ayman Abouleid
  1. General Surgery, King Fahd Military Medical Complex, Dhahran, Saudi Arabia
  1. Correspondence to Dr Ahmed Mohammed AlMuhsin, amuhsin90{at}


Limy bile syndrome is a rare entity in which there is an excessive precipitation of calcium salts, mainly calcium carbonate in the gallbladder (GB) and to a rare extent in the common bile duct (CBD), making it radiopaque in plain radiographs. Laparoscopic cholecystectomy is safe and effective in patients with limy bile confined to the GB. However, for patients with an extension to the CBD, bile duct exploration with a T-tube placement, endoscopic naso-billiary drainage or endoscopic sphincterotomy (EST) may be warranted. We report a case of limy bile syndrome associated with obstructive jaundice in a young female patient. She was managed successfully with EST followed by laparoscopic cholecystectomy.

  • biliary intervention
  • surgery
  • endoscopy

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  • Contributors AMA contributed in the development of the intellectual content, reviewed the literature and wrote the manuscript. AAl drafted the manuscript and reviewed the literature. AAb supervised the management of the patient and reviewed the manuscript. All authors read and approved the final manuscript.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Patient consent for publication Obtained.

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