{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,8,27]],"date-time":"2025-08-27T16:40:01Z","timestamp":1756312801145,"version":"3.44.0"},"reference-count":13,"publisher":"BMJ","issue":"9","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2019,9,7]]},"published-print":{"date-parts":[[2019,9]]},"abstract":"<jats:p>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.<\/jats:p>","DOI":"10.1136\/bcr-2019-231798","type":"journal-article","created":{"date-parts":[[2019,9,19]],"date-time":"2019-09-19T16:45:23Z","timestamp":1568911523000},"page":"e231798","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":4,"title":["Endoscopic management of limy bile syndrome presenting with obstructive jaundice"],"prefix":"10.1136","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7932-1891","authenticated-orcid":false,"given":"Ahmed Mohammed","family":"AlMuhsin","sequence":"first","affiliation":[{"name":"General Surgery, King Fahd Military Medical Complex, Dhahran, Saudi Arabia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ahmad","family":"Altaweel","sequence":"additional","affiliation":[{"name":"General Surgery, King Fahd Military Medical Complex, Dhahran, Saudi Arabia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ayman","family":"Abouleid","sequence":"additional","affiliation":[{"name":"General Surgery, King Fahd Military Medical Complex, Dhahran, Saudi Arabia"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2019,9,19]]},"reference":[{"key":"2025082709110099000_12.9.e231798.1","doi-asserted-by":"crossref","first-page":"349","DOI":"10.5009\/gnl.2009.3.4.349","article-title":"Endoscopic management of acute cholecystitis and cholangitis caused by limy bile","volume":"3","author":"Lee","year":"2009","journal-title":"Gut Liver"},{"key":"2025082709110099000_12.9.e231798.2","first-page":"223","article-title":"Acute cholecystitis with large amount o\u00ed calcium soap in the gallbladder","volume":"22","author":"Churchman","year":"1911","journal-title":"Bull Johns Hopkins Hosp"},{"key":"2025082709110099000_12.9.e231798.3","doi-asserted-by":"crossref","first-page":"44","DOI":"10.2169\/internalmedicine.42.44","article-title":"Limy bile syndrome complicated with primary hyperparathyroidism","volume":"42","author":"Takatori","year":"2003","journal-title":"Intern Med"},{"key":"2025082709110099000_12.9.e231798.4","doi-asserted-by":"publisher","DOI":"10.1111\/j.1445-2197.2005.03523.x"},{"key":"2025082709110099000_12.9.e231798.5","doi-asserted-by":"publisher","DOI":"10.1136\/bcr-2018-228061"},{"key":"2025082709110099000_12.9.e231798.6","first-page":"751","article-title":"A rare case of Mirizzi syndrome due to pure calcium carbonate stones (Limy Bile)","volume":"66","author":"Gilani","year":"2016","journal-title":"J Pak Med Assoc"},{"key":"2025082709110099000_12.9.e231798.7","first-page":"49","article-title":"Limy bile syndrome complicated by obstructive jaundice","volume":"95","author":"Sasaki","year":"2010","journal-title":"Int Surg"},{"key":"2025082709110099000_12.9.e231798.8","doi-asserted-by":"crossref","first-page":"59","DOI":"10.1111\/ases.12317","article-title":"Successful treatment of limy bile syndrome extending to the common bile duct by laparoscopic cholecystectomy and common bile duct exploration: A case report and literature review","volume":"10","author":"Masuda","year":"2017","journal-title":"Asian J Endosc Surg"},{"key":"2025082709110099000_12.9.e231798.9","doi-asserted-by":"crossref","first-page":"220","DOI":"10.1097\/00004836-199404000-00010","article-title":"Spontaneous disappearance of limy bile. A cause of acute pancreatitis?","volume":"18","author":"Levy","year":"1994","journal-title":"J Clin Gastroenterol"},{"key":"2025082709110099000_12.9.e231798.10","doi-asserted-by":"crossref","first-page":"e27","DOI":"10.1016\/j.cgh.2011.10.027","article-title":"Unenhanced computed tomography to identify intrahepatic and extrahepatic limy bile","volume":"10","author":"Peroux","year":"2012","journal-title":"Clin Gastroenterol Hepatol"},{"key":"2025082709110099000_12.9.e231798.11","first-page":"884","article-title":"Spontaneous disappearance of limy bile: report of a case with review of the literature","volume":"79","author":"Nomura","year":"1984","journal-title":"Am J Gastroenterol"},{"key":"2025082709110099000_12.9.e231798.12","doi-asserted-by":"crossref","first-page":"809","DOI":"10.1016\/S0016-5085(61)80056-5","article-title":"Radiographic demonstration of spontaneous disappearance of limy bile","volume":"40","author":"Schwartz","year":"1961","journal-title":"Gastroenterology"},{"key":"2025082709110099000_12.9.e231798.13","doi-asserted-by":"crossref","first-page":"1","DOI":"10.2169\/internalmedicine.42.1","article-title":"Management of limy bile syndrome: no therapy, laparotomy or endoscopic treatment?","volume":"42","author":"Itoh","year":"2003","journal-title":"Intern Med"}],"container-title":["BMJ Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bcr-2019-231798","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,8,27]],"date-time":"2025-08-27T16:11:09Z","timestamp":1756311069000},"score":1,"resource":{"primary":{"URL":"https:\/\/casereports.bmj.com\/lookup\/doi\/10.1136\/bcr-2019-231798"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2019,9]]},"references-count":13,"journal-issue":{"issue":"9","published-online":{"date-parts":[[2019,9,19]]},"published-print":{"date-parts":[[2019,9]]}},"alternative-id":["10.1136\/bcr-2019-231798"],"URL":"https:\/\/doi.org\/10.1136\/bcr-2019-231798","relation":{},"ISSN":["1757-790X"],"issn-type":[{"type":"electronic","value":"1757-790X"}],"subject":[],"published":{"date-parts":[[2019,9]]}}}