title: Emphysematous Cholecystitis Resulting in Secondary Biliary Cirrhosis: A Rare Complication of Endoscopic Retrograde Cholangiopancreatography.
abstract: A 48-year-old female developed acute emphysematous cholecystitis after an endoscopic retrograde cholangiopancreatography (ERCP) for evaluation of sphincter of Oddi dysfunction. Cholecystectomy was performed 2 days later. Cultures grew Clostridium perfringens. The patient received broad-spectrum antibiotics but developed recurrent cholangitic abscesses and intra- and extra-hepatic biliary necrosis. She was managed by percutaneous transhepatic biliary drains. For next 3 years, patient had recurrent episodes of biliary obstruction, cholangitis, and sepsis, resulting in secondary biliary cirrhosis requiring a liver transplantation. Emphysematous cholecystitis is a rare complication of ERCP. Prompt diagnosis and surgical management can prevent further spread of infection to biliary tree.
authors.affiliation: Department of Digestive Diseases, Yale University School of Medicine, New Haven, CT.
authors.forename: Khurram
authors.initials: K
authors.lastname: Bari
authors.affiliation: Department of Digestive Diseases, Yale University School of Medicine, New Haven, CT.
authors.forename: Harry R
authors.initials: HR
authors.lastname: Aslanian
authors.affiliation: Department of Interventional Radiology, Yale University School of Medicine, New Haven, CT.
authors.forename: Jeffrey
authors.initials: J
authors.lastname: Pollak
authors.affiliation: Department of Interventional Radiology, Yale University School of Medicine, New Haven, CT.
authors.forename: Eric
authors.initials: E
authors.lastname: Reiner
authors.affiliation: Department of Surgery, Yale University School of Medicine, New Haven, CT.
authors.forename: Ronald R
authors.initials: RR
authors.lastname: Salem
authors.affiliation: Department of Digestive Diseases, Yale University School of Medicine, New Haven, CT.
authors.forename: Tamar H
authors.initials: TH
authors.lastname: Taddei
authors.affiliation: Yale New Haven Transplantation Center, Transplantation and Immunology, New Haven, CT.
authors.forename: Sukru H
authors.initials: SH
authors.lastname: Emre
authors.affiliation: Department of Digestive Diseases, Yale University School of Medicine, New Haven, CT.
authors.forename: Priya A
authors.initials: PA
authors.lastname: Jamidar