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ERCP may provoke hemobilia from trauma to friable hilar tumors or a guide-wire penetrating the bile duct wall, creating a biliary fistula. Delayed bleeding is a rare but potentially serious complication of sphincterotomy, particularly as many patients are discharged home within hours of ERCP.
Common bile duct stone, also known as choledocholithiasis, is the presence of gallstones in the common bile duct (CBD) (thus choledocho-+ lithiasis). This condition can cause jaundice and liver cell damage. Treatments include choledocholithotomy and endoscopic retrograde cholangiopancreatography (ERCP).
Diagnosis includes abdominal ultrasounds. A wide range of symptoms makes the diagnosis of biloma difficult. Delayed diagnosis 77% of patients resulted from abdominal bile collections and bile leaks after a laparoscopic cholecystectomy. [1] Radiographic imaging is used to diagnose and confirm bile leaks.
Signs and symptoms of a bile leak include abdominal pain, tenderness, fever and signs of sepsis several days following surgery, or through laboratory studies as rising total bilirubin and alkaline phosphatase. [22] Complications from a bile leak can follow a person for years and can lead to death.
Cholecystitis is suspected based on symptoms and laboratory testing. [5] Abdominal ultrasound is then typically used to confirm the diagnosis. [5] Treatment is usually with laparoscopic gallbladder removal, within 24 hours if possible. [7] [10] Taking pictures of the bile ducts during the surgery is recommended. [7]
Obstruction of the common bile duct with gallstones can sometimes be relieved by endoscopic retrograde sphincterotomy (ERS) following endoscopic retrograde cholangiopancreatography (ERCP). [54] Risks of ERCP. [55] Surgery carries risks and some people continue to experience symptoms (including pain) afterwards, for reasons that remain unclear.
A biliary stricture, leak, or obstruction may be the injury's outward manifestation. A history of gallbladder empyema or gangrenous cholecystitis as reasons for cholecystectomy should raise the possibility of biliary injury. If the bile duct injury is not recognized right away, the patient may present with bile in the drain, if one was left in ...
Such patients usually present with bilioptysis (presence of bile in sputum), persistent cough, chest infections, or respiratory distress due to pleural effusion. Bilioptysis is the pathognomonic clinical feature of BBF. [1] Extensive ascites may accumulate, especially in the setting of sterile bile leakage, which is often asymptomatic in nature.