Case Report
Copyright ©2007 Baishideng Publishing Group Co., Limited. All rights reserved.
World J Gastroenterol. Aug 14, 2007; 13(30): 4152-4153
Published online Aug 14, 2007. doi: 10.3748/wjg.v13.i30.4152
Plasmapheresis and corticosteroid treatment for persistent jaundice after successful drainage of common bile duct stones by endoscopic retrograde cholangiography
Ulku Saritas, Bunyamin Aydin, Yucel Ustundag
Ulku Saritas, Bunyamin Aydin, Gastroneterology Department, Süleyman Demirel University, School of Medicine, Turkey
Yucel Ustundag, Gastroenterology Department, Zonguldak Karaelmas University, School of Medicine, Turkey
Author contributions: All authors contributed equally to the work.
Correspondence to: Yucel Ustundag, Gastroenterology Department, Zonguldak Karaelmas University, School of Medicine, Bagcilar 5. sok 7/4 Ceren Apt Gaziosmanpasa 06100 Ankara, Turkey. yucel_u@yahoo.com
Fax: +90-37-22610169
Received: March 20, 2007
Revised: April 1, 2007
Accepted: April 4, 2007
Published online: August 14, 2007
Abstract

Prolonged cholestasis is a very rare complication of endoscopic retrograde cholangiography (ERC). Only few cases with this complication are reported in the English literature. We report persisting cholestatic jaundice in a 73-year old man after successful therapeutic ERC for choledocholithiasis. Serologic tests for viral and autoimmune hepatitis were all negative. A second-look ERC was normal also. He denied any medication except for prophylaxis given intravenous 1 g ceftriaxon prior to the ERC procedure. After an unsuccessful trial with ursodeoxycholic acid and cholestyramine for 2 wk, this case was efficiently treated with corticosteroids and plasmapheresis. His cholestatic enzymes became normal and intense pruritis quickly resolved after this treatment which lasted during his follow-up period. We discussed the possible mechanisms and treatment alternatives of intrahepatic cholestasis associated with the ERC procedure.

Keywords: Endoscopic retrograde cholangiography; Cholestasis; Plasmapheresis