title: Severe acute cholangitis after endoscopic sphincterotomy induced by barium examination: A case report.
abstract: Endoscopic sphincterotomy (EST) is considered as a possible etiological factor for severe cholangitis. We herein report a case of severe cholangitis after endoscopic sphincterotomy induced by barium examination. An adult male patient presented with epigastric pain was diagnosed as having choledocholithiasis by ultrasonography. EST was performed and the stone was completely cleaned. Barium examination was done 3 d after EST and severe cholangitis appeared 4 h later. The patient was recovered after treated with tienam for 4 d. Barium examination may induce severe cholangitis in patients after EST, although rare, barium examination should be chosen cautiously. Cautions should be also used when EST is performed in patients younger than 50 years to avoid the damage to the sphincter of Oddi.
authors.affiliation: Department of Hepatobiliary Surgery, Shandong Provincial Hospital-Shangdong University, Jinan, Shandong Province, China. zhangzhenhai410@yahoo.com.cn
authors.forename: Zhen-Hai
authors.initials: ZH
authors.lastname: Zhang
authors.forename: Ya-Guang
authors.initials: YG
authors.lastname: Wu
authors.forename: Cheng-Kun
authors.initials: CK
authors.lastname: Qin
authors.forename: Zhong-Xue
authors.initials: ZX
authors.lastname: Su
authors.forename: Jian
authors.initials: J
authors.lastname: Xu
authors.forename: Guo-Zhe
authors.initials: GZ
authors.lastname: Xian
authors.forename: Shuo-Dong
authors.initials: SD
authors.lastname: Wu
mesh_terms: D000328:Adult; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D001464:Barium / Q000009:adverse effects*; D002761:Cholangitis / Q000188:drug therapy / Q000209:etiology*; D042883:Choledocholithiasis / Q000601:surgery; D015377:Cilastatin / Q000627:therapeutic use; D000077728:Cilastatin, Imipenem Drug Combination; D004338:Drug Combinations; D006801:Humans; D015378:Imipenem / Q000627:therapeutic use; D008297:Male; D011480:Protease Inhibitors / Q000627:therapeutic use; D016717:Sphincterotomy, Endoscopic / Q000009:adverse effects*
chemical_list: D000900:Anti-Bacterial Agents; D004338:Drug Combinations; D011480:Protease Inhibitors; D015377:Cilastatin; D001464:Barium; D015378:Imipenem; D000077728:Cilastatin, Imipenem Drug Combination
keywords: Barium examination; Endoscopic sphincterotomy; Severe cholangitis; Sphincter of Oddi