Intermittent common bile duct obstruction at ampulla of Vater due to chicken bone impaction: diagnosis by hepatobiliary imaging.

A patient with intermittent ascending cholangitis was evaluated for extrahepatic biliary obstruction with Tc-99m-pyridoxylidene glutamate. Imaging demonstrated incomplete obstruction of the distal common bile duct. At surgery, a chicken bone was found to be impacted at the ampulla of Vater in the afferent limb of a Billroth II gastroenterostomy.