Inflammatory Bile Duct Obstruction during the Healing Stage of Severe Acute Pancreatitis

The patient was a 62-year-old woman with a history of severe acute pancreatitis complicated by walled-off necrosis (WON), who developed obstructive jaundice during the recovery phase from WON. Magnetic resonance cholangiopancreatography (MRCP) and endoscopic retrograde cholangiopancreatography (ERCP...

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Bibliographic Details
Published in:Internal Medicine 2017/05/01, Vol.56(9), pp.1037-1040
Main Authors: Yamabe, Akane, Irisawa, Atsushi, Shibukawa, Goro, Sato, Ai, Fujisawa, Mariko, Arakawa, Noriyuki, Yoshida, Yoshitsugu, Igarashi, Ryo, Maki, Takumi, Yamamoto, Shogo, Ikeda, Tsunehiko, Abe, Yoko, Hoshi, Koki
Format: Article
Language:English
Subjects:
acute pancreatitis
Bile
bile duct obstruction
Bile ducts
Case Report
Cholangiopancreatography, Endoscopic Retrograde
Cholangiopancreatography, Magnetic Resonance
Cholestasis - diagnostic imaging
Cholestasis - etiology
Cholestasis - pathology
Endoscopy
Endosonography
Etiology
Female
Fibrosis
Humans
Inflammation
Internal medicine
Jaundice
Jaundice, Obstructive - etiology
Malignancy
Middle Aged
Pancreatitis
Pancreatitis - complications
Pancreatitis - diagnostic imaging
Pancreatitis - surgery
Stricture
Treatment Outcome
Ultrasound
walled-off necrosis
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Summary:The patient was a 62-year-old woman with a history of severe acute pancreatitis complicated by walled-off necrosis (WON), who developed obstructive jaundice during the recovery phase from WON. Magnetic resonance cholangiopancreatography (MRCP) and endoscopic retrograde cholangiopancreatography (ERCP) revealed the complete obstruction of the distal bile duct, and endoscopic ultrasonography (EUS) revealed thickening of the duct wall, with a uniform distribution, and a relatively well-preserved layered structure. A cytopathological examination using ERCP showed no malignancy. The underlying etiology of this case may have been the formation of a cicatricial stricture during the resolution of WON, in addition to fibrosis caused by the spreading of inflammation from pancreatitis.
ISSN:0918-2918
1349-7235
DOI:10.2169/internalmedicine.56.7859