A Case Report of Unstable Hemoglobinopathy with Cholecystocholedocholithiasis

Shigeyoshi Itoh, Akira Kubo, Toshimichi Takahashi, Ryoto Suzuki, Kohsuke Matsui*

Department of Surgery, Yokosuka City Municipal Hospital
*Department of Internal Medicine, Yokosuka City Municipal Hospital

The association of cholelithiasis with some hemolytic diseases including spherocytosis and the surgical treatment of cholelithiasis have been well documented. But cholelithiasis with unstable hemoglobinopathy has not been reported. We present a case of cholecysto-choledocholithiasis after past splenectomy with unstable hemoglobinopathy. The patient was a 17-year-old male. Splenectomy was performed because of unstable hemoglobinopathy when he was 4 years old. He was admitted to our hospital with the chief complaint of epigastralgia. Abdominal ultrasonography revealed gall stones. Cholecystectomy, choledochotomy and transduodenal-sphincteroplasty were performed. The calculi in the gall bladder and common bile duct contained 90% bilirubin calcium and 10% calcium carbonate. In general splenectomy is the surgical treatment for hemolytic disease. In addition to this operation, indications for simultaneous prophylactic cholecystectomy and splenectomy or sphincteroplasty deserve further study.

Key words
cholelithiasis, unstable hemoglobin, hemoglobin Santa Ana

Reprint requests
Shigeyoshi Itoh Department of Surgery, Yokosuka City Municipal Hospital
1-3-2 Nagasaka, Yokosuka City, 240-01 JAPAN

Accepted
October 11, 1990

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