Ampullary duodenal diverticulum and cholangitis.
BACKGROUND
Ampullary duodenal diverticulum complicated by cholangitis is little known in clinical practice, especially when there are no gallstones in the common bile duct or there is no biliary tree ectasia or hyperamylasemia. A case of this association is presented, in which the surgical treatment was a biliary-enteric bypass.


METHODS
A 74-year-old diabetic white woman was admitted to the Taubat University Hospital, complaining of pain in the right upper quadrant, jaundice and fever with chills (Charcot's triad). She had had cholecystectomy 30 years earlier. She underwent clinical treatment with parenteral hydration, insulin, antibiotics and symptomatic drugs. Imaging examinations were provided for diagnosis: ultrasound, computed tomography and endoscopic retrograde cholangiopancreatography. The surgical treatment consisted of choledochojejunostomy utilizing a Roux-en-y loop. The postoperative period progressed without incidents, and a DISIDA scan demonstrated the presence of dynamic biliary excretion. The patient remained asymptomatic when seen at outpatient follow-up.
Surgical Clinical Service, Hospital Universitário, Department of Medical Sciences, Universidade de Taubaté, Taubaté, São Paulo, Brazil. jmcnetto@uol.com.br
Joaquim Mendes
JM
Castilho Netto
Manlio Basilio
MB
Speranzini
D000368:Aged; D002761:Cholangitis / Q000209:etiology* / Q000601:surgery; D004238:Diverticulitis / Q000150:complications* / Q000601:surgery; D004378:Duodenal Diseases / Q000150:complications* / Q000601:surgery; D005260:Female; D006801:Humans; D014057:Tomography, X-Ray Computed