Case Report
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World J Gastroenterol. Oct 21, 2012; 18(39): 5658-5660
Published online Oct 21, 2012. doi: 10.3748/wjg.v18.i39.5658
Severe acute cholangitis after endoscopic sphincterotomy induced by barium examination: A case report
Zhen-Hai Zhang, Ya-Guang Wu, Cheng-Kun Qin, Zhong-Xue Su, Jian Xu, Guo-Zhe Xian, Shuo-Dong Wu
Zhen-Hai Zhang, Ya-Guang Wu, Cheng-Kun Qin, Zhong-Xue Su, Jian Xu, Guo-Zhe Xian, Department of Hepatobiliary Surgery, Shandong Provincial Hospital Affiliated to Shangdong University, Jinan 250021, Shandong Province, China
Zhen-Hai Zhang, Guo-Zhe Xian, Shuo-Dong Wu, the Second Department of General Surgery, the Second Affiliated Hospital of China Medical University, Shenyang 110004, Liaoning Province, China
Author contributions: Zhang ZH and Wu SD contributed equally to this work; Zhang ZH and Wu SD designed the research; Wu YG and Qin CK discussed the clinical features of the patient; Xu J and Xian GZ analyzed data; Zhang ZH, Wu YG, Qin CK and Su ZX wrote the paper.
Correspondence to: Dr. Shuo-Dong Wu, the Second Department of General Surgery, the Second Affiliated Hospital of China Medical University, No. 36 Sanhao Street, Heping District, Shenyang 110004, Liaoning Province, China. zhangzhenhai410@yahoo.com.cn
Telephone: +86-531-85186363 Fax: +86-531-85186363
Received: March 24, 2012
Revised: June 7, 2012
Accepted: June 15, 2012
Published online: October 21, 2012
Abstract

Endoscopic sphincterotomy (EST) is considered as a possible etiological factor for severe cholangitis. We herein report a case of severe cholangitis after endoscopic sphincterotomy induced by barium examination. An adult male patient presented with epigastric pain was diagnosed as having choledocholithiasis by ultrasonography. EST was performed and the stone was completely cleaned. Barium examination was done 3 d after EST and severe cholangitis appeared 4 h later. The patient was recovered after treated with tienam for 4 d. Barium examination may induce severe cholangitis in patients after EST, although rare, barium examination should be chosen cautiously. Cautions should be also used when EST is performed in patients younger than 50 years to avoid the damage to the sphincter of Oddi.

Keywords: Endoscopic sphincterotomy; Severe cholangitis; Barium examination; Sphincter of Oddi