Clin Endosc.  2012 Mar;45(1):99-102. 10.5946/ce.2012.45.1.99.

An Impacted Pancreatic Stone in the Papilla Induced Acute Obstructive Cholangitis in a Patient with Chronic Pancreatitis

Affiliations
  • 1Digestive Disease Center, CHA Bundang Medical Center, CHA University, Seongnam, Korea. endoscopy@cha.ac.kr

Abstract

Obstructive jaundice is very rarely caused by impaction of a pancreatic stone in the papilla. We report here on a case of obstructive jaundice with acute cholangitis that was caused by an impacted pancreatic stone in the papilla in a patient with chronic pancreatitis. A 48-year-old man presented with acute obstructive cholangitis. Abdominal computed tomography with the reconstructed image revealed distal biliary obstruction that was caused by a pancreatic stone in the pancreatic head, and there was also pancreatic ductal dilatation and parenchymal atrophy of the pancreatic body and tail with multiple calcifications. Emergency duodenoscopy revealed an impacted pancreatic stone in the papilla. Precut papillotomy using a needle knife was performed, followed by removal of the pancreatic stone using grasping forceps. After additional sphincterotomy, a large amount of dark-greenish bile juice gushed out. The patient rapidly improved and he has remained well.

Keyword

Cholangitis; Obstructive jaundice; Pancreatic stone; Chronic pancreatitis; Endoscopic sphincterotomy
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