title: Gallstone in jejunal limb with jejunocolonic fistula 10 years after Roux-en-Y choledochojejunostomy.
abstract: Roux-en-Y choledochojejunostomy is a common biliary reconstruction procedure. The collection of gallstones in the jejunal limb is a rare complication. Here we present a case of a 61-year-old Chinese female who received Roux-en-Y choledochojejunostomy 10 years ago. Diagnosis of recurrent bile duct stones accompanying infection was made before operation. She also had an abdominal mass which was possibly an intussuscepted colon or a huge fecolith. At laparotomy, an oval stone (5 cm in diameter) and 3 smaller multifaceted stones (2 cm in diameter) were found in the jejunal limb. A fistula between this jejunum and colon was also found. Although the typical manifestations of diarrhea were present, the diagnosis of a biliary colonic fistula was missed before operation. Partial colectomy was performed with the fistulous opening repaired. A T-tube was left in the jejunal limb and the mesocolon aperture was enlarged and revised. Her postoperative convalescence was uneventful. We report this case hoping to sharpen our diagnostic acumen.
authors.affiliation: Tao Suo, Lu-Jun Song, Sai-Xiong Tong, Department of General Surgery, Zhongshan Hospital, Fudan University, General Surgery Institute of Fudan University, Shanghai 200032, China.
authors.forename: Tao
authors.initials: T
authors.lastname: Suo
authors.forename: Lu-Jun
authors.initials: LJ
authors.lastname: Song
authors.forename: Sai-Xiong
authors.initials: SX
authors.lastname: Tong