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Painless obstructive jaundice secondary to a common bile duct abscess: a delayed sequela of cholecystectomy.

Fairhurst K, Strickland A, Bridgewater FH, Maddern GJ - HPB Surg (2009)

Bottom Line: Most occur in the early postoperative period and are recognised either at the time of, or shortly after surgery.In this paper we present a unique case of an abscess of the common bile duct wall, presenting with painless obstructive jaundice more than 30 years following an open cholecystectomy, without the presence of gallstones.The clinical presentation, investigations, and treatment are discussed with a review of other relevant reported cases in the literature.

View Article: PubMed Central - PubMed

Affiliation: The Queen Elizabeth Hospital, University of Adelaide Discipline of Surgery, Woodville, South Australia, SA 5011, Australia.

ABSTRACT
Complications related to cholecystectomy are well described. Most occur in the early postoperative period and are recognised either at the time of, or shortly after surgery. Clinical sequelae occurring years following cholecystectomy are rare and infrequently reported. In addition, most delayed complications are related to the continuing presence or new formation of gallstones. In this paper we present a unique case of an abscess of the common bile duct wall, presenting with painless obstructive jaundice more than 30 years following an open cholecystectomy, without the presence of gallstones. The clinical presentation, investigations, and treatment are discussed with a review of other relevant reported cases in the literature.

No MeSH data available.


Related in: MedlinePlus

Stricture of the proximal bile duct at ERCP.
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Related In: Results  -  Collection


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fig1: Stricture of the proximal bile duct at ERCP.

Mentions: She was referred to the gastroenterologists at a tertiary centre for endoscopic retrograde cholangiopancreatography (ERCP). The images at ERCP demonstrated a round filling defect approximately 2 cm in diameter associated with a smooth stricture consistent with extrinsic compression in the proximal bile duct (Figure 1). The common bile duct was cannulated without difficulty and measured 8 mm in diameter. A guidewire was easily placed past the area of compression and insertion of a 10 French; 12 cm Cotton Leung biliary stent was performed. The jaundice resolved within 72 hours of the procedure. No antibiotics were given at the time of the ERCP. No malignant cells were identified from the aspirated bile sent for histology. The patient was discharged the day following the ERCP and referral to the hepatopancreaticobiliary surgical team was made for further investigation into the cause of the jaundice.


Painless obstructive jaundice secondary to a common bile duct abscess: a delayed sequela of cholecystectomy.

Fairhurst K, Strickland A, Bridgewater FH, Maddern GJ - HPB Surg (2009)

Stricture of the proximal bile duct at ERCP.
© Copyright Policy - open-access
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC2801000&req=5

fig1: Stricture of the proximal bile duct at ERCP.
Mentions: She was referred to the gastroenterologists at a tertiary centre for endoscopic retrograde cholangiopancreatography (ERCP). The images at ERCP demonstrated a round filling defect approximately 2 cm in diameter associated with a smooth stricture consistent with extrinsic compression in the proximal bile duct (Figure 1). The common bile duct was cannulated without difficulty and measured 8 mm in diameter. A guidewire was easily placed past the area of compression and insertion of a 10 French; 12 cm Cotton Leung biliary stent was performed. The jaundice resolved within 72 hours of the procedure. No antibiotics were given at the time of the ERCP. No malignant cells were identified from the aspirated bile sent for histology. The patient was discharged the day following the ERCP and referral to the hepatopancreaticobiliary surgical team was made for further investigation into the cause of the jaundice.

Bottom Line: Most occur in the early postoperative period and are recognised either at the time of, or shortly after surgery.In this paper we present a unique case of an abscess of the common bile duct wall, presenting with painless obstructive jaundice more than 30 years following an open cholecystectomy, without the presence of gallstones.The clinical presentation, investigations, and treatment are discussed with a review of other relevant reported cases in the literature.

View Article: PubMed Central - PubMed

Affiliation: The Queen Elizabeth Hospital, University of Adelaide Discipline of Surgery, Woodville, South Australia, SA 5011, Australia.

ABSTRACT
Complications related to cholecystectomy are well described. Most occur in the early postoperative period and are recognised either at the time of, or shortly after surgery. Clinical sequelae occurring years following cholecystectomy are rare and infrequently reported. In addition, most delayed complications are related to the continuing presence or new formation of gallstones. In this paper we present a unique case of an abscess of the common bile duct wall, presenting with painless obstructive jaundice more than 30 years following an open cholecystectomy, without the presence of gallstones. The clinical presentation, investigations, and treatment are discussed with a review of other relevant reported cases in the literature.

No MeSH data available.


Related in: MedlinePlus