title: Limy bile syndrome: review of seven cases.
abstract: BACKGROUND
  Milk of calcium bile or limy bile is a rare disorder in which the gall bladder is filled with a thick, paste-like, radiopaque material.
  
  
  METHODS
  Seven patients with limy bile syndrome were treated in our department from 1980 to 2003. There were five women and two men, and their age ranged from 30 to 64 years. A retrospective analysis of clinical symptoms, diagnostic work-up, treatment approach and operative findings was performed.
  
  
  RESULTS
  All patients presented with intermittent right upper abdominal quadrant pain. Three of the seven patients (42.85%) presented with complications like acute cholecystitis (two of seven patients) and obstructive jaundice (one of seven patients). Diagnosis was based on clinical findings, plain abdominal X-rays, ultrasonography and computed tomography scanning. Surgery was the treatment of choice and cholecystectomy alone or in combination with common bile duct exploration and drainage (if needed) was performed.
  
  
  CONCLUSIONS
  The clinical aspect of the disease is similar to that of biliary lithiasis and the diagnosis is easily made by the characteristic spontaneous opacification of the gall bladder on plain abdominal X-rays. Complications such as acute cholecystitis, pancreatitis or obstructive jaundice can also be present. Although some cases of conservative pharmaceutical treatment as well as cases of spontaneous disappearance of limy bile have been reported, surgical treatment remains the treatment of choice.
authors.affiliation: Second Propedeutical Department of Surgery, Aristotelian University of Thessaloniki, Hippokration General Hospital of Thessaloniki, Greece.
authors.forename: Konstantinos D
authors.initials: KD
authors.lastname: Ballas
authors.forename: Michael B
authors.initials: MB
authors.lastname: Alatsakis
authors.forename: Savas F
authors.initials: SF
authors.lastname: Rafailidis
authors.forename: Kiriakos
authors.initials: K
authors.lastname: Psarras
authors.forename: Athanassios K
authors.initials: AK
authors.lastname: Sakadamis
mesh_terms: D000328:Adult; D001646:Bile / Q000737:chemistry*; D002119:Calcium Carbonate / Q000032:analysis; D002764:Cholecystitis / Q000150:complications; D005260:Female; D005705:Gallbladder Diseases / Q000175:diagnosis* / Q000601:surgery; D006801:Humans; D041781:Jaundice, Obstructive / Q000150:complications; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies
chemical_list: D002119:Calcium Carbonate