title: Advanced hyperbilirubinemia simulating obstructive jaundice after choledocholithotomy. Report of a case.
abstract: A case of intrahepatic cholestatic jaundice of unclear etiology and unusual course is described. A male patient underwent choledocholithotomy after PTC, showing a normal immediate postoperative recovery, but after a few days developed a severe cholestatic jaundice despite normal postoperative cholangiograms. The liver function tests showed a biphasic picture. Bilirubin was maximally 770 mumol/l and a lower level was obtained after blood exchange and subphrenic abscess drainage. It was, however, not until prednisolone treatment was induced that a slow continuous decrease of bilirubin was seen.
mesh_terms: D000368:Aged; D001803:Blood Transfusion; D002779:Cholestasis / Q000188:drug therapy / Q000209:etiology*; D004318:Doxycycline / Q000627:therapeutic use; D042882:Gallstones / Q000601:surgery*; D006801:Humans; D006932:Hyperbilirubinemia / Q000188:drug therapy / Q000209:etiology*; D008297:Male; D011183:Postoperative Complications; D011239:Prednisolone / Q000627:therapeutic use
chemical_list: D011239:Prednisolone; D004318:Doxycycline