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2021, Number 5

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Medisur 2021; 19 (5)

Radiological clinical case of recurrent pyogenic cholangitis

Vergara SA, Reyes VJM, Sosa FA
Full text How to cite this article

Language: Spanish
References: 14
Page: 863-871
PDF size: 302.94 Kb.


Key words:

hepatolithiasis, recurrent pyogenic cholangitis, oriental cholangiohepatitis.

ABSTRACT

A 28-year-old Bangladeshi patient is presented, admitted to the Cuban Hospital in Qatar for:abdominal pain, moderate fever and mild jaundice, elevated liver and pancreatic enzymes, as well as a humoral pattern of cholestasis. Abdominal ultrasound and abdominal tomography with intravenous contrast detected a distended gallbladder with a thick wall, lithiasis in the extra and intrahapatic bile ducts with dilatation of the same and little amount of fluid and peri-pancreatic edema, concluding as acute pancreatitis secondary to lithiasic cholecystitis. An endoscopic retrograde cholangiopancreatography was performed, verifying these findings and stenosis of the right hepatic duct associated with non-patency of the left hepatic duct, the diagnosis changed to oriental pyogenic cholangitis. By this route, the stones were extracted and a stent was placed. The patient was treated with complementary antibiotics, piperazine and IV tazobactam, and was discharged with satisfactory evolution nine days after admission. He is now being followed by a multidisciplinary team to define definitive surgical conduct.


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Medisur. 2021;19