A case of acute pancreatitis due to biliary stone impacted at the papilla Vatery treated by emergent ERCP

Abstract

Acute pancreatitis which is a serious disease can lead to mortality in a small group of patients. One of the main causes of acute pancreatitis is biliary stone (40-60%). Endoscopic Retrograde Cholangiopancreaticography can be a life saving procedure in some patients with obstructed stone clinic such as icterus, elevated cholestatic enzymes and biliary dilatation. In this report, emergent therapy of a biliary stone which is impacted at the papilla Vatery and caused acute pancreatitis has been presented.

Keywords

• Acute pancreatitis, biliary stone, Endoscopic Retrograde Cholangiopancreaticography

Acil ERCP ile tedavi edilen papilla Vateri'ye sıkışmış taşın neden olduğu bir akut biliyer pankreatit vakası

Öz

Akut pankreatit mortal seyirli olabilen önemli bir hastalıktır. Akut pankreatitlerin %40-60 nedeni safra yolu taşlarıdır. Bu yüzden akut pankreatitli hastalarda obstrüksiyon bulguları saptandığında (sarılık, hiperbilirubinemi, kolestaz enzimlerinde yükseklik ve safra yollarında dilatasyon) acil terapötik Endoskopik Retrograd Kolanjiyopankreatikografi yapılması hayat kurtarıcı olabilir. Burada akut pankreatite neden olan papilla Vateriye şıkışmış biliyer taşın acil tedavisi sunulmuştur.

Anahtar Kelimeler

• Akut pankreatit, safra yolu taşı, Endoskopik Retrograd Kolanjiyopankreatikografi

Kaynakça

1. Charbonney E, Nathens AB. Severe acute pancreatitis: a review. Surg In- fect (Larchmt) 2008; 9: 573-8.
2. Bradley EL 3rd. A clinically based classification system for acute pancre- atitis. Summary of the International Symposiumon Acute Pancreatitis, Atlanta, GA, September 11–13, 1992. Arch Surg 1993; 128: 586-90.
3. Makary MA, Duncan MD, Harmon JW, et al. The role of magnetic reso- nance cholangiography in the management of patients with gallstone pancreatitis. Ann Surg 2005; 241: 119-24.
4. Winslet M, Imray C, Neoptolemos JP. Biliary acute pancreatitis. Hepato- gastroenterology 1991; 38: 120-3.
5. UK working party on acute pancreatitis. UK guidelines for the manage- ment of acute pancreatitis. Gut 2005; 54 (Suppl 3): 1-9.
6. Fan ST, Lai EC, Mok FP, et al. Early treatment of acute biliary pancreati- tis by endoscopic papillotomy. N Engl J Med 1993; 328: 228-32.
7. Neoptolemos JP, Carr-Locke DL, London NJ, et al. Controlled trial of ur- gent endoscopic retrograde cholangiopancreatography and endoscopic sphincterotomy versus conservative treatment for acute pancreatitis due to gallstones. Lancet 1988; 2: 979-83.
8. Liu CL, Fan ST, Lo CM, et al. Comparison of early endoscopic ultraso- nography and endoscopic retrograde cholangiopancreatography in the management of acute biliary pancreatitis: A prospective randomized study. Clin Gastroenterol Hepatol 2005; 3: 1238-44.