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

Akane Yamabe; Atsushi Irisawa; Goro Shibukawa; Ai Sato; Mariko Fujisawa; Noriyuki Arakawa; Yoshitsugu Yoshida; Ryo Igarashi; Takumi Maki; Shogo Yamamoto; Tsunehiko Ikeda; Yoko Abe; Koki Hoshi

doi:10.2169/internalmedicine.56.7859

CASE REPORTS

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

Akane Yamabe, Atsushi Irisawa, Goro Shibukawa, Ai Sato, Mariko Fujisawa, Noriyuki Arakawa, Yoshitsugu Yoshida, Ryo Igarashi, Takumi Maki, Shogo Yamamoto, Tsunehiko Ikeda, Yoko Abe, Koki Hoshi

Author information

Akane Yamabe
Department of Gastroenterology, Aizu Medical Center, Fukushima Medical University, Japan
Atsushi Irisawa
Department of Gastroenterology, Aizu Medical Center, Fukushima Medical University, Japan
Goro Shibukawa
Department of Gastroenterology, Aizu Medical Center, Fukushima Medical University, Japan
Ai Sato
Department of Gastroenterology, Aizu Medical Center, Fukushima Medical University, Japan
Mariko Fujisawa
Department of Gastroenterology, Aizu Medical Center, Fukushima Medical University, Japan
Noriyuki Arakawa
Department of Gastroenterology, Aizu Medical Center, Fukushima Medical University, Japan
Yoshitsugu Yoshida
Department of Gastroenterology, Aizu Medical Center, Fukushima Medical University, Japan
Ryo Igarashi
Department of Gastroenterology, Aizu Medical Center, Fukushima Medical University, Japan
Takumi Maki
Department of Gastroenterology, Aizu Medical Center, Fukushima Medical University, Japan
Shogo Yamamoto
Department of Gastroenterology, Aizu Medical Center, Fukushima Medical University, Japan
Tsunehiko Ikeda
Department of Gastroenterology, Aizu Medical Center, Fukushima Medical University, Japan
Yoko Abe
Department of Gastroenterology, Aizu Medical Center, Fukushima Medical University, Japan
Koki Hoshi
Department of Gastroenterology, Aizu Medical Center, Fukushima Medical University, Japan

Keywords: acute pancreatitis, walled-off necrosis, bile duct obstruction

JOURNAL OPEN ACCESS

2017 Volume 56 Issue 9 Pages 1037-1040

DOI https://doi.org/10.2169/internalmedicine.56.7859

Details

Abstract

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.

Corresponding author

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