[Clinical features of patients with choledocholithiasis showing high levels of aminotransferases].
OBJECTIVE
We aimed to determine the clinical features of patients with common bile duct (CBD) stones with high serum levels of AST or ALT.


METHODS
A retrospective review of 93 patients with CBD stones was done. Clinical characteristics, diameters of CBD, and prior diagnosis before endoscopic retrograde cholangiopancreatography (ERCP) were assessed between two groups (group 1 with serum AST or ALT levels > or =400 IU/L and group 2 with AST and ALT < or =100 IU/L).


RESULTS
Nineteen patients in group 1 and 17 patients in group 2 were enrolled. The most common presenting symptom was abdominal pain in both groups. Patients in group 1 was about 14 years younger than group 2 (p=0.003). The duration of symptoms in group 1 and group 2 were 4.1 and 36.8 days, respectively (p=0.005). The diameter of CBD was smaller in group 1 (11.4 mm) than in group 2 (16.3 mm) (p=0.001). Most patients were diagnosed as CBD stones by abdominal ultrasound or computed tomography before ERCP, except two patients in group 1 who were diagnosed as hepatitis initially. All of the patients were recovered by stone removal through ERCP and antibiotics treatment. There were inverse correlations between the diameter of CBD and AST or ALT levels (r=-0.517, p=0.002 and r=-0.504, p=0.002, respectively).


CONCLUSIONS
CBD stones with high levels of AST or ALT are frequently observed in younger patients with shorter duration of symptoms and a smaller diameter of CBD. ERCP seems to be a valuable method in the diagnosis and treatment of these patients.
Department of Internal Medicine, Chungbuk National University College of Medicine and Medical Research Institute, Cheongju, Korea.
Won Joong
WJ
Jeon
Joung Ho
JH
Han
Jeong Chul
JC
Seo
Seon Mee
SM
Park
Hee Bok
HB
Chae
Sei Jin
SJ
Youn
D000368:Aged; D000410:Alanine Transaminase / Q000097:blood*; D001219:Aspartate Aminotransferases / Q000097:blood*; D002760:Cholangiopancreatography, Endoscopic Retrograde; D042883:Choledocholithiasis / Q000175:diagnosis* / Q000201:enzymology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged
D001219:Aspartate Aminotransferases; D000410:Alanine Transaminase