Mehul Choksi, MD, DM, Mahesh Desai, MS, FIAGES VideoGIE

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Migrated surgical clips within bile duct stone suspected on EUS and verified on ERCP Mehul Choksi, MD, DM, Mahesh Desai, MS, FIAGES VideoGIE Volume 2, Issue 3, Pages 59-61 (March 2017) DOI: 10.1016/j.vgie.2016.12.011 Copyright © 2017 The Authors Terms and Conditions

Figure 1 Linear EUS image from second part of the duodenum showing 2 calculi in the distal common bile duct. The proximal calculus shows 2 parallel hyperechoic foci (arrow) within the calculus suggestive of surgical clips. VideoGIE 2017 2, 59-61DOI: (10.1016/j.vgie.2016.12.011) Copyright © 2017 The Authors Terms and Conditions

Figure 2 Another image of the calculus in the common bile duct showing surgical clips (arrow) within the body of the calculus. VideoGIE 2017 2, 59-61DOI: (10.1016/j.vgie.2016.12.011) Copyright © 2017 The Authors Terms and Conditions

Figure 3 Cholangiogram showing large bile duct stone with 2 parallel radiopaque line shadows (arrow) within the stone suggestive of surgical clips. VideoGIE 2017 2, 59-61DOI: (10.1016/j.vgie.2016.12.011) Copyright © 2017 The Authors Terms and Conditions

Figure 4 Extracted bile duct stone with 3 embedded surgical clips (arrow) in the duodenal lumen. VideoGIE 2017 2, 59-61DOI: (10.1016/j.vgie.2016.12.011) Copyright © 2017 The Authors Terms and Conditions

Figure 5 Extracted stone with clips outside the GI lumen. VideoGIE 2017 2, 59-61DOI: (10.1016/j.vgie.2016.12.011) Copyright © 2017 The Authors Terms and Conditions

Figure 6 Dislodged clips from the stone. VideoGIE 2017 2, 59-61DOI: (10.1016/j.vgie.2016.12.011) Copyright © 2017 The Authors Terms and Conditions