CASE REPORT
Limy bile syndrome or milk of calcium bile: An unexpected encounter
 
More details
Hide details
1
IGKC Multispeciality Hospital, Bhubaneswar, India
 
2
Hi-Tech Medical College and Hospital, Bhubaneswar, India
 
 
Submission date: 2023-09-01
 
 
Final revision date: 2023-11-26
 
 
Acceptance date: 2023-11-26
 
 
Online publication date: 2024-02-01
 
 
Corresponding author
Mitali Madhumita Rath   

Consultant Pathologist, IGKC Multispeciality Hospital, Bhubaneswar
 
 
Pol. Ann. Med. 2024;31(1):30-33
 
KEYWORDS
TOPICS
ABSTRACT
Introduction:
Limy bile or milk of calcium bile caused due to precipitation of calcium salts in bile is an extremely rare condition of gall bladder, wherein the lumen of gall bladder is filled with chalky white paste like material. Not many cases have been reported till date.

Aim:
In this exceptional case, we tried to correlate the radiological and surgical findings with the histopathology.

Case study:
We hereby present an interesting case of a 59-year-old male who presented with dyspepsia and painful abdomen and was finally diagnosed with limy bile syndrome.

Results and discussion:
The etiology of this rare entity is not fully understood, but it certainly has strong association with impacted stone at the neck of gall bladder and hyperparathyroidism. Females are more commonly affected than males. Patients usually present with complaints of painful abdomen and are commonly diagnosed radiologically, as a radiopacity in gall bladder. Cholecystectomy is the preferred method of treatment for this unusual condition and histopathologically chronic cholecystitis is seen along with presence of slender needle shaped crystals of calcium salts.

Conclusions:
A thorough evaluation of the clinicoradiological and histopathological findings can sometimes bring to light many uncommon variants of common looking pathologies.

FUNDING
This study has no funding.
CONFLICT OF INTEREST
Authors declare that they have no conflicts of interest.
 
REFERENCES (10)
1.
Rahate NP, Rahate PV. Limy bile syndrome: A report of a rare case. Cureus. 2022;30:14(7):e27473. https://doi.org/10.7759%2Fcure....
 
2.
Arif SH, Mohammed AA. Limy bile (Milk of calcium bile) associated with gall stones discovered incidentally during laparoscopic cholecystectomy. Int J Surg Case Rep. 2019;61:127–129. https://doi.org/10.1016/j.ijsc....
 
3.
AlMuhsin AM, Altaweel A, Abouleid A. Endoscopic management of limy bile syndrome presenting with obstructive jaundice. BMJ Case Rep. 2019;12(9):e231798. https://doi.org/10.1136/bcr-20....
 
4.
Mohammed AA, Arif SH. Limy bile syndrome presenting as acute acalculous cholecystitis. BMJ Case Rep. 2019;12(4):e228061. https://doi.org/10.1136/bcr-20....
 
5.
Takatori Y, Yamauchi K, Negoro Y, et al. Limy bile syndrome complicated with primary hyperparathyroidism. Intern Med. 2003;42(1):44–47. https://doi.org/10.2169/intern....
 
6.
Ballas KD, Alatsakis MB, Rafailidis SF, Psarras K, Sakadamis AK. Limy bile syndrome: review of seven cases. ANZ J Surg. 2005;75(9):787–789. https://doi.org/10.1111/j.1445....
 
7.
Onghena T, De Waele JJ, Vereecken L, Van Loon C. Limy bile and laparoscopic cholecystectomy. Acta Chir Belg. 2001;101(1):31–34.
 
8.
Sasaki T, Kato D, Matsuoka N, Yamashita Y. Limy bile syndrome complicated by obstructive jaundice. Int Surg. 2010;95(1):49–53.
 
9.
Masuda Y, Mizuguchi Y, Kanda T, et al. 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. Asian J Endosc Surg. 2017;10(1):59–62. https://doi.org/10.1111/ases.1....
 
10.
Koca YS, Koca T, Barut I. Limy bile syndrome complicated with primary hyperparathyroidism. Case Rep Surg. 2015;2015:928217. https://doi.org/10.1155%2F2015....
 
Journals System - logo
Scroll to top