{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,8,28]],"date-time":"2025-08-28T10:40:01Z","timestamp":1756377601359,"version":"3.44.0"},"reference-count":21,"publisher":"BMJ","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["BMJ Case Reports"],"abstract":"<jats:p>A 44-year-old Caucasian woman without any identified predisposing factors, presented to her local emergency room with multiple episodes of recurrent ascending cholangitis. She underwent a laparoscopic cholecystectomy several years prior to her admission to the hospital for parenteral antibiotic therapy and she had no personal or family history of hypercholesterolaemia. Transferred to a tertiary hospital for surgical therapy, she underwent a left hepatic resection for a chronically infected left lobe hepatolithiasis (HL) conditioning atrophy of the parenchyma due to obstruction of the biliary tree by multiple large cholesterol stones. HL is a very rare condition in Western countries and its aetiology and predisposing factors are still unclear. We present her symptomatology, diagnostic and therapeutic management and discuss the epidemiology and risk factors of HL, that is, a common condition in South East Asia while exceptional in Caucasian patients who have not travelled in high-prevalence regions.<\/jats:p>","DOI":"10.1136\/bcr-2012-007239","type":"journal-article","created":{"date-parts":[[2012,10,30]],"date-time":"2012-10-30T13:00:22Z","timestamp":1351602022000},"page":"bcr2012007239","source":"Crossref","is-referenced-by-count":0,"title":["A rare grade III symptomatic Tsunoda class III left lobe hepatolithiasis in a North American woman"],"prefix":"10.1136","volume":"2012","author":[{"given":"Bassam","family":"Abu-Wasel","sequence":"first","affiliation":[{"name":"Department of Surgery, Dalhousie University, Halifax, Nova Scotia, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Valerie","family":"Keough","sequence":"additional","affiliation":[{"name":"Department of Radiology, Dalhousie University, Halifax, Nova Scotia, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michele","family":"Molinari","sequence":"additional","affiliation":[{"name":"Department of Surgery, Dalhousie University, Halifax, Nova Scotia, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2012,10,30]]},"reference":[{"key":"2025082803035414000_2012.oct30_1.bcr2012007239.1","doi-asserted-by":"publisher","DOI":"10.1308\/003588406X98711"},{"issue":"(4)","key":"2025082803035414000_2012.oct30_1.bcr2012007239.2","first-page":"540","article-title":"Primary intrahepatic stones","volume":"90","author":"Kim","year":"1995","journal-title":"Am J Gastroenterol"},{"key":"2025082803035414000_2012.oct30_1.bcr2012007239.3","doi-asserted-by":"publisher","DOI":"10.1016\/j.bpg.2006.05.010"},{"key":"2025082803035414000_2012.oct30_1.bcr2012007239.4","doi-asserted-by":"crossref","first-page":"194","DOI":"10.1111\/j.1477-2574.2009.00046.x","article-title":"Surgical management of hepatolithiasis","volume":"11","author":"Sakpal","year":"2009","journal-title":"HPB (Oxford)"},{"key":"2025082803035414000_2012.oct30_1.bcr2012007239.5","doi-asserted-by":"publisher","DOI":"10.1111\/j.1572-0241.2003.08770.x"},{"key":"2025082803035414000_2012.oct30_1.bcr2012007239.6","first-page":"51","article-title":"Surgical treatment of hepatolithiasis. Presentation of a case","volume":"90","author":"Manzanera","year":"1998","journal-title":"Rev Esp Enferm Dig"},{"key":"2025082803035414000_2012.oct30_1.bcr2012007239.7","doi-asserted-by":"crossref","first-page":"137","DOI":"10.1016\/S0009-739X(02)71946-5","article-title":"[Hepatectom\u00eda en 4 pacientes con litiasis intrahep\u00e1tica.]","volume":"71","author":"Robles","year":"2002","journal-title":"Cir Esp"},{"key":"2025082803035414000_2012.oct30_1.bcr2012007239.8","doi-asserted-by":"crossref","first-page":"661","DOI":"10.1007\/s00464-003-0015-8","article-title":"Intrahepatic lithiasis as a late complication of hepaticojejunostomy","volume":"17","author":"Lazaridis","year":"2003","journal-title":"Surg Endosc"},{"key":"2025082803035414000_2012.oct30_1.bcr2012007239.9","doi-asserted-by":"publisher","DOI":"10.1097\/00004836-200108000-00001"},{"key":"2025082803035414000_2012.oct30_1.bcr2012007239.10","doi-asserted-by":"publisher","DOI":"10.1007\/s00268-006-0441-6"},{"key":"2025082803035414000_2012.oct30_1.bcr2012007239.11","doi-asserted-by":"publisher","DOI":"10.1007\/BF02470091"},{"key":"2025082803035414000_2012.oct30_1.bcr2012007239.12","doi-asserted-by":"publisher","DOI":"10.1002\/bjs.1800176804"},{"key":"2025082803035414000_2012.oct30_1.bcr2012007239.13","first-page":"28","article-title":"Hepatolithiasis: a Turkey experience","volume":"18","author":"Kayhan","year":"2007","journal-title":"Turk J Gastroenterol"},{"key":"2025082803035414000_2012.oct30_1.bcr2012007239.14","doi-asserted-by":"publisher","DOI":"10.2214\/AJR.05.0247"},{"key":"2025082803035414000_2012.oct30_1.bcr2012007239.15","doi-asserted-by":"publisher","DOI":"10.1016\/j.bpg.2006.05.009"},{"key":"2025082803035414000_2012.oct30_1.bcr2012007239.16","doi-asserted-by":"crossref","first-page":"677","DOI":"10.1148\/radiol.2202001252","article-title":"Recurrent pyogenic cholangitis: comparison between MR cholangiography and direct cholangiography","volume":"220","author":"Park","year":"2001","journal-title":"Radiology"},{"key":"2025082803035414000_2012.oct30_1.bcr2012007239.17","doi-asserted-by":"crossref","first-page":"1171","DOI":"10.1016\/S0033-8389(22)02472-1","article-title":"Biliary sonography","volume":"29","author":"Cohen","year":"1991","journal-title":"Radiol Clin North Am"},{"issue":"(1 Pt 1)","key":"2025082803035414000_2012.oct30_1.bcr2012007239.18","doi-asserted-by":"crossref","first-page":"165","DOI":"10.1148\/radiology.170.1.2909092","article-title":"Evaluation of recurrent pyogenic cholangitis with CT: analysis of 50 patients","volume":"170","author":"Chan","year":"1989","journal-title":"Radiology"},{"key":"2025082803035414000_2012.oct30_1.bcr2012007239.19","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjsurg.2008.08.020"},{"key":"2025082803035414000_2012.oct30_1.bcr2012007239.20","doi-asserted-by":"publisher","DOI":"10.1159\/000172115"},{"key":"2025082803035414000_2012.oct30_1.bcr2012007239.21","doi-asserted-by":"publisher","DOI":"10.1001\/archsurg.137.2.149"}],"container-title":["BMJ Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bcr-2012-007239","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,8,28]],"date-time":"2025-08-28T10:04:02Z","timestamp":1756375442000},"score":1,"resource":{"primary":{"URL":"https:\/\/casereports.bmj.com\/lookup\/doi\/10.1136\/bcr-2012-007239"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2012,10,30]]},"references-count":21,"alternative-id":["10.1136\/bcr-2012-007239"],"URL":"https:\/\/doi.org\/10.1136\/bcr-2012-007239","relation":{},"ISSN":["1757-790X"],"issn-type":[{"type":"electronic","value":"1757-790X"}],"subject":[],"published":{"date-parts":[[2012,10,30]]}}}