Obstructive blood thrombus formation in the common bile duct probably due to a silk ligature. Report of a case.

The case of a 59-year-old, jaundiced male is reported. Autopsy revealed an obstructing blood thrombus in the common bile duct. The thrombus was firmly attached to the duct wall. Microscopic remnants of thread material were found in the centre of the thrombus, but not elsewhere. Approximately 10 months prior to death an elective and uncomplicated cholecystectomy was performed, and the cystic duct was ligated with silk. The unabsorbable thread material is supposed to have migrated through the duct wall, resulting in secondary inflammatory reaction, bleeding and finally the formation of an intra-luminal thrombus. The clinical manifestations were largely in agreement with the patho-anatomical findings.