keywords: #Acute suppurative cholangitis, common bile duct,
ERCP, cholangiogram, #stent.
A 38-year-old lactating woman presented with severe
epigastric pain that is referred to the back was admitted to the endoscopy
unit.
fig4( insertion of plastic stent into the CBD)
fig3( cholangiogram of CBD and intrahepatic bile ducts
fig2(cholangiogram of CBD)
Fig1( cannulation of CBD using guidewire and ERCPcannula)
. Abdominal ultrasound revealed gall bladder stones, diagnosed 4 years ago
and dilated CBD with a stone in its lumen. Laboratory investigations showed
leukocytosis, white blood cell count 12.4 × 103, normal range(4.3-10.8×103), international normalized ratio 1,32 (normal
range 1-1.7), alanine aminotransferase 233, (normal up to 40
IU/L), aspartate aminotransferase 398, (normal up to 40 IU/L),
lipase 40( normal < 60U/L). The patient underwent endoscopic
retrograde cholangiopancreatography. The scope revealed normally located
papilla. Cannulation was done using an ERCP cannula, a cholangiogram revealed
mildly dilated CBD. A wide sphincterotomy was done. The scope also showed an
excessive amount of pus, whitish color coming out from the papilla denoting
#acute suppurative cholangitis. Plastic stent 9×10 French was deployed into the
CBD. Also, the stent opening showing pus coming out from the stent opening.
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