title: Pyogenic cholangitis after inadvertent submucosal contrast injection in the papilla of Vater in a patient with cholestatic hepatitis.
abstract: Common bile duct stones and tumors constitute the leading cause of acute biliary tract obstruction and cholangitis. Septic complications after diagnostic endoscopic retrograde cholangiopancreatography (ERCP) are very unusual in unobstructed bile ducts. There are only three reported cases of patients without evidence of biliary tract disease who developed cholangitis and liver abscesses due to Pseudomonas aeruginosa. Biliary endoscopists believe that the inadvertent submucosal injection of contrast into the papilla of Vater is an innocent accident that has no serious consequences other than increasing the percentage of unsuccessful catheterizations of the common bile duct. Herein we describe a patient with drug-induced cholestatic hepatitis who developed pyogenic cholangitis after the inadvertent injection of submucosal contrast in the papilla of Vater.
authors.affiliation: Department of Endoscopy and Motility Unit, Central Hospital, Ethnikis Aminis 41, TK 546 35 Thessaloniki, Greece. pantso@the.forthnet.gr
authors.forename: P
authors.initials: P
authors.lastname: Katsinelos
authors.forename: I
authors.initials: I
authors.lastname: Pilpilidis
authors.forename: G
authors.initials: G
authors.lastname: Paroutoglou
authors.forename: P
authors.initials: P
authors.lastname: Tsolkas
authors.forename: I
authors.initials: I
authors.lastname: Galanis
authors.forename: G
authors.initials: G
authors.lastname: Fotiadis
authors.forename: P
authors.initials: P
authors.lastname: Kapelidis
authors.forename: E
authors.initials: E
authors.lastname: Kamperis
authors.forename: D
authors.initials: D
authors.lastname: Katsiba
authors.forename: E
authors.initials: E
authors.lastname: Georgiadi
authors.forename: C
authors.initials: C
authors.lastname: Koutras
authors.forename: S
authors.initials: S
authors.lastname: Dimiropoulos
mesh_terms: D000368:Aged; D014670:Ampulla of Vater; D056486:Chemical and Drug Induced Liver Injury / Q000175:diagnosis* / Q000601:surgery; D002758:Cholangiography; D002760:Cholangiopancreatography, Endoscopic Retrograde / Q000009:adverse effects*; D002761:Cholangitis / Q000209:etiology* / Q000628:therapy; D002763:Cholecystectomy; D003287:Contrast Media / Q000008:administration & dosage*; D004322:Drainage; D006801:Humans; D007267:Injections / Q000009:adverse effects*; D008099:Liver / Q000648:ultrastructure; D008297:Male; D011552:Pseudomonas Infections / Q000175:diagnosis / Q000209:etiology* / Q000628:therapy; D013492:Suppuration / Q000209:etiology; D014057:Tomography, X-Ray Computed
chemical_list: D003287:Contrast Media