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Milk of Calcium Gallbladder – Limy Bile Syndrome: A Rare Cause of Gallbladder Disease

Christoforos S. Kosmidis, Georgios D. Koimtzis, Konstantinos G. Sapalidis, Nikolaos Michalopoulos, Stylianos V. Mantalovas, Aikaterini T. Zarampouka, Eleni Georgakoudi, Isaac Kesisoglou

(Department of Surgery, Interbalkan European Medical Center, Thessaloniki, Greece)

Med Sci Case Rep 2017; 4:61-63

DOI: 10.12659/MSCR.905349


BACKGROUND: Milk of calcium gallbladder or limy bile syndrome is a rare disorder in which the gallbladder lumen is filled with a semisolid radiopaque material composed mainly of calcium carbonate or oxalate. The etiopathogenesis remains unclear, although gallbladder stasis is believed to be a key factor.
CASE REPORT: A 37-year-old female presented with abdominal pain, nausea, vomiting, and flatulence. The abdomen ultrasound scan revealed a gallstone in the gallbladder, while the computed tomography (CT) scan showed a calcified chololithiasis. The patient was submitted to exploratory laparoscopy, which revealed multiple adhesions due to a previous operation. Thus, the procedure was transformed into an open laparotomy and a cholecystectomy was performed. The patient had an uneventful recovery and was discharged on the third post-operative day.
CONCLUSIONS: Limy bile syndrome is a rare cause of gallbladder disease, mostly affecting women over 40 years old, whose etiology has not yet been fully understood. Its symptoms and complications seem to be the result of biliary lithiasis rather than limy bile syndrome itself. Abdominal X-rays, CT scan, magnetic retrograde cholangiopancreatography (MRCP), and ultrasound are used for diagnosis, which is usually incidental. More research is needed on this syndrome.

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