# Secondary choledocholithiasis caused by fish bones: a case report and review of the literature

## TL;DR

A case report and literature review show that fish bones can cause secondary bile duct stones, with endoscopic treatment being a key solution.

## Contribution

This paper presents a rare case of secondary choledocholithiasis caused by fish bones and reviews literature on foreign body-induced biliary stones.

## Key findings

- Fish bones can act as foreign bodies leading to secondary choledocholithiasis.
- Endoscopic retrograde cholangiopancreatography is a preferred treatment for biliary foreign bodies.
- Biliary complications from foreign bodies should be considered even years after initial procedures.

## Abstract

Foreign body in the common bile duct can act as a nidus for stone formation, leading to secondary choledocholithiasis. Currently there are very few reviews concerning biliary stones caused by foreign bodies; this article may offer some help for relevant situations.

We retrospectively analyzed the case of an 89-year-old Chinese (Han ethnicity, Asian) male patient with secondary choledocholithiasis caused by fish bones. We also present a review of the literature regarding choledocholithiasis caused by foreign bodies using “foreign body case” and “common bile duct stone” as the search terms in the PubMed database. The analysis of patient demographics, foreign body origins, clinical presentations, treatments, and outcomes may provide some suggestions for the management of those specific biliary foreign body cases.

Even years after cholecystectomy, endoscopic retrograde cholangiopancreatography, or foreign body ingestion, biliary complications secondary to foreign body migration should still be considered. The clinical presentation of most biliary foreign bodies is similar to choledocholithiasis. endoscopic retrograde cholangiopancreatography can serve as the preferred treatment modality. When endoscopic retrograde cholangiopancreatography fails, repeating endoscopic retrograde cholangiopancreatography or conversion to surgery should be considered.

The online version contains supplementary material available at 10.1186/s13256-025-05705-1.