An uncommon cause of abdominal pain after endoscopic retrograde cholangiopancreatography

Abstract

346 An uncommon cause of abdominal pain after endoscopic retrograde cholangiopancreatography 1 3 A 50-year-old woman was admitted to another hospital with the complaints of intermittent right upper abdominal pain, jaundice, and chills in the last 10 years. Past medical history was significant for cholecystectomy and choledochoduodenostomy operations because of cholelithiasis and cystic dilation in the common bile duct 25 years ago. Physical examination revealed right upper abdominal tenderness. Laboratory parameters showed an increase in alanine aminotransferase: 401 U/L (reference range: 10–49), aspartate aminotransferase: 870 U/L (0–34), and gamma-glutamyl transpeptidase: 422 U/L (0–38) levels. Magnetic resonance cholangiography disclosed dilation in the intrahepatic bile ducts and cystic dilation in the common hepatic duct. The patient was referred to our hospital for endoscopic retrograde cholangiopancreatography (ERCP). ERCP revealed cystic dilation of the common hepatic duct, dilation of the common bile duct and multiple stones between the choledochoduodenostomy anastomosis and the ampulla of Vater. A diagnosis of Sump syndrome was reached. Common bile duct was cannulated after precut papillotomy. Some of the stones were extracted by standard balloon technique and a 12 cm 10 F stent was inserted. Patient suffered from moderate abdominal pain 2 days after the procedure. Physical Wiener klinische Wochenschrift The Central European Journal of Medicine Wien Klin Wochenschr (2013) 125:346–347 DOI 10.1007/s00508-013-0368-5