Acute pancreatitis following choledochoscopic stone extraction for hepatolithiasis

Shyr Ming Sheen-Chen, Hock Liew Eng

Research output: Contribution to journalArticle

2 Citations (Scopus)

Abstract

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.

Original languageEnglish
Pages (from-to)CS13-CS15
JournalMedical Science Monitor
Volume9
Issue number4
Publication statusPublished - Apr 1 2003
Externally publishedYes

Keywords

  • Acute pancreatitis
  • Hepatolithiasis

ASJC Scopus subject areas

  • Medicine(all)

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