Edamame (green soy beans) biliary stones.

To cite: Iriyama H, Kato M, Nogami M, et al. BMJ Case Rep Published online: [please include Day Month Year] doi:10.1136/bcr-2014207677 DESCRIPTION We present the case of an 89-year-old tiny woman who presented with a 2-day history of fever. Her medical history included gallbladder stones, hypertension, osteoporosis, rheumatoid arthritis and dementia. Vital signs showed an elevated temperature of 38.3°C and tachypnoea. She was frail with a body weight of 28 kg. There was no abnormality on the abdominal examination. However, abdominal CT scan showed dilation of common bile duct with numerous large-sized stones (figure 1) mimicking ‘edamame’ (figure 2). For diagnosis of acute cholangitis associated with common bile duct stones, antibiotics were initiated and endoscopic stone removal was conducted with a complication of retroperitoneal perforation, which was treated conservatively; placement of metal biliary stent was conducted secondarily. After the procedure the patient made a good clinical course and she was eventually discharged home. Learning points