Hemorrhage as a Complication of Common Duct Stones

Intrinsic bleeding from the common bile duct consequent to erosion of a blood vessel by a stone is a relatively infrequent-occurring entity, but its infrequency and, still more, the difficulty of common duct investigation combine to make its diagnosis difficult even after profuse hemorrhage supervenes. The immediate precipitating factor responsible for the bleeding is no doubt an erosion into a blood vessel by an overlying stone. Loss of blood may be trivial if the vessel is affected by some pathological process, or severe if it is normal. We⁵ previously reported two cases of massive bleeding from the common bile duct produced as a result of irritation of the ductal mucosa by an indwelling T-tube. A similar instance with fatal hemorrhage from choledochal bleeding was reported by Campbell.¹ In Campbell's case intracholedochal intubation was responsible for the ulceration into and hemorrhage from the posterior superior pancreaticoduodenal artery. White and