TY - JOUR
T1 - Acute pancreatitis following choledochoscopic stone extraction for hepatolithiasis
AU - Sheen-Chen, Shyr Ming
AU - Eng, Hock Liew
PY - 2003/4/1
Y1 - 2003/4/1
N2 - Background: Hepatolithiasis is prevalent in Southeast Asia and presents a difficult treatment problem. The main purposes of treatment are clearance of the stones and elimination of bile stasis. Acute pancreatitis due to migratory gall bladder stone is a well documented phenomenon. To the best of our knowledge, there is no previous report of acute pancreatitis due to intrahepatic stone. We report an intriguing case of acute pancreatitis subsequent to postoperative choledochoscopy for residual intrahepatic stone. Case Report: The patient, a 56-year-old male, suffered from intermittent epigastralgia for about 2 years. Endoscopic retrograde cholangiopancreatography (ERCP) performed after admission showed incomplete contrast filling of the right intrahepatic duct. The patient underwent surgical intervention with the diagnosis of right intrahepatic stones. Postoperative T-tube cholangiography demonstrated impacted right intrahepatic stones behind the stricture. Postoperative matured T-tube tract ductal dilatation (2-4) was begun about 4 weeks after the operation. Choledochoscopy was performed after dilatation. After the third postoperative choledocoscopy for residual stone extraction, the patient complained of abdominal pain the next day. Abdominal CT showed distal common bile duct stone and acute pancreatitis. After medical treatment, patient recovered uneventfully. Conclusion: Extrahepatic ductal migration with resultant acute pancreatitis is possible in patients with hepatolithiasis. The awareness of such a possibility enables clinicians to promptly recognize and appropriately manage this kind of acute pancreatitis.
AB - Background: Hepatolithiasis is prevalent in Southeast Asia and presents a difficult treatment problem. The main purposes of treatment are clearance of the stones and elimination of bile stasis. Acute pancreatitis due to migratory gall bladder stone is a well documented phenomenon. To the best of our knowledge, there is no previous report of acute pancreatitis due to intrahepatic stone. We report an intriguing case of acute pancreatitis subsequent to postoperative choledochoscopy for residual intrahepatic stone. Case Report: The patient, a 56-year-old male, suffered from intermittent epigastralgia for about 2 years. Endoscopic retrograde cholangiopancreatography (ERCP) performed after admission showed incomplete contrast filling of the right intrahepatic duct. The patient underwent surgical intervention with the diagnosis of right intrahepatic stones. Postoperative T-tube cholangiography demonstrated impacted right intrahepatic stones behind the stricture. Postoperative matured T-tube tract ductal dilatation (2-4) was begun about 4 weeks after the operation. Choledochoscopy was performed after dilatation. After the third postoperative choledocoscopy for residual stone extraction, the patient complained of abdominal pain the next day. Abdominal CT showed distal common bile duct stone and acute pancreatitis. After medical treatment, patient recovered uneventfully. Conclusion: Extrahepatic ductal migration with resultant acute pancreatitis is possible in patients with hepatolithiasis. The awareness of such a possibility enables clinicians to promptly recognize and appropriately manage this kind of acute pancreatitis.
KW - Acute pancreatitis
KW - Hepatolithiasis
UR - http://www.scopus.com/inward/record.url?scp=0038559644&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=0038559644&partnerID=8YFLogxK
M3 - Article
C2 - 12709674
AN - SCOPUS:0038559644
SN - 1234-1010
VL - 9
SP - CS13-CS15
JO - Medical Science Monitor
JF - Medical Science Monitor
IS - 4
ER -