Abstract
BackgroundLately, the humanity has been being threatened by the coronavirus disease (COVID-19). The virus-related destructive motives can damage not only the lungs but also the brain, blood vessels, kidneys, and the heart.Case presentationA middle-aged female presented with jaundice post-COVID-19 pneumonia. The patient had past history of cholecystectomy 20 years ago. Both laboratory and imaging data revealed a picture of cholestasis with right lobe liver abscess. Despite drainage and culture-based antibiotics, no improvement ensued. Endoscopic retrograde cholangiopancreatography was done revealing mildly dilated common bile duct (CBD), multiple large stones, mildly dilated central biliary radicals, and an old overlooked stent inside the dilated CBD. Papillotomy and papilloplasty were undertaken followed by stones’ extraction with insertion of 2 plastic stents (10 cm× 10 f), and a flow of thick dark bile was inspected. The patient was finally improved and safely discharged.ConclusionHerein, we present the first case of long-retained quiescent biliary stent which was over-headed by a cholangitic abscess in the vicinity of COVID pneumonia.
Highlights
The humanity has been being threatened by the coronavirus disease (COVID-19)
Conclusion: we present the first case of long-retained quiescent biliary stent which was over-headed by a cholangitic abscess in the vicinity of COVID pneumonia
Further assessment in the following days has confirmed the condition as non-resolving abscess. This nonresponse to the classic measures of abscess treatment added to the sonographic findings and the cholestatic liver derangement had mandated stepping to endoscopic retrograde cholangiography (ERCP)
Summary
The emerging COVID-19 disease has been considered this century’s lethal curse [1]. Since the first strenuous apprehension from the Chinese city Wuhan, lots of data has been evolving concerning the novel coronavirus [1]. Clinical examination revealed scleral icterus and significant tenderness over the right hypochondrium. Her history was significant for COVID-19 pneumonia and ICU admission for around 22 days in a nearby hospital 1 month earlier. The clinical status of the patient did not show any improvement with persistent fever, discharge from the pigtail, and non-change in sonographic measures of the abscess cavity. Further assessment in the following days has confirmed the condition as non-resolving abscess. This nonresponse to the classic measures of abscess treatment (culture-based antibiotics and percutaneous drainage) added to the sonographic findings and the cholestatic liver derangement had mandated stepping to endoscopic retrograde cholangiography (ERCP).
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