Endoscopic retrograde cholangiography

A 65-year-old man presented with severe abdominal pain 90 minutes after taking codeine and low-dose paracetamol. Serum amylase and lipase were significantly raised. Liver function tests were moderately abnormal. Abdominal ultrasound and CT scan showed edematous pancreatitis. Endoscopic retrograde cholangiography showed a papilla with a spastic appearance and an abnormal bile duct. He recovered completely, but 3 months later took codeine and paracetamol after a hemorrhoidectomy abdominal pain recurred 1 hour later and acute pancreatitis was confirmed. 

Endoscopic retrograde cholangiography with biliary obstruction Biliary tract surgery... 

Abbreviations CT, computer tomography ERCP, endoscopic-retrograde-cholangiography IVP, intravenous-pyelography. 

Fig. 14.4. a Endoscopic retrograde cholangiography that shows the presence of a bile duct stenosis, b Percutaneous cholangiography that shows the presence of multiple stenoses in the bile ducts. The prostheses are occluded, c Cholangiography performed after the placement of an internal-external drainage catheter... 

Fig. 1.6a-d. Rendezvous procedure for a distal CBD stricture with failed endoscopic retrograde cholangiography, a CT shows a distal biliary obstruction along with multiple liver metastasis (arrow), b The stricture of the distal common bile duct was negotiated and an 8-F multi-sidehole catheter was inserted (arrow). This facilitated endoscopic bile duct cannulation (c) and subsequent stent placement (d)... 

Stippel DL, Tox U, Gossmann A, et al (2003) Successful treatment of radiofrequency-induced biliary lesions by interventional endoscopic retrograde cholangiography (ERC). Surg Endosc 17 1965-1970... 

Endoscopic retrograde cholangiopancreatography and transhepatic cholangiography in patients with suspected obstructive jaundice. A randomized study. Scand. X Gastroenterol. 1982 17 731-735... 

In 27 patients who received intrahepatic floxuridine, total dose 20-41 mg/kg extrahepatic biliary sclerosis was discovered by CT scan and ultrasound, followed by endoscopic retrograde cholangiopancreatography and/or percutaneous cholangiography in three cases (4). Radiological findings included complete obstruction of the common hepatic duct in one case, common hepatic duct stenosis in two cases, common bile duct obstruction in one case, and intrahepatic bile duct dilatation without identifiable obstruction in one case... 

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