Discussion in 'All Categories' started by Niraj Girase - Jul 1st, 2012 7:59 am. | |
![]() Niraj Girase
|
A patient suffered by hyperbilirubinemia & bilirubin level increased to 7.2 & it was found that the bile duct was blocked.Doctor advised gastroscopy & the stent was placed in right bile duct only because stenting in left bile duct was not possible due to very much narrowness.But again after 2 months the stent slipped but bilirubin level came to 1.8 before the stent slipped.Now once again stenting is done by gastroscopy but still patient suffers high fever. What are causes of fever & what precaution taken? |
re: Blockage of bile duct.
by Dr J S Chowhan -
Jul 1st, 2012
10:40 am
#1
|
|
![]() Dr J S Chowhan
|
Dear Niraj Girase You did not tell use what is the cause of blockage in your patient case as it could be due to stone or due to malignancy. The stent in CBD is introduced by ERCP and if there is fever after ERCP then there is chance of infection cholangitis or pancreatitis. Endoscopic retrograde cholangiopancreatography (ERCP) is not as innocent procedure as it was thought once upon a time and definitely it is an invasive procedure that is performed to identify and treat pancreatic and biliary disease. In approximately 5%-10% of cases who go for ERCP, the procedure itself causes adverse events. Diagnosis and management of ERCP-induced complications are carried out with clinical, laboratory, and radiologic procedures. Evaluation of the type and severity of the complication is essential and it is successfully performed with computed tomography (CT). The most common causes of post-ERCP pain are acute pancreatitis and duodenal perforation. In severe pancreatitis, the pancreas is enlarged and enhances heterogeneously at CT. Pancreatic enhancement is diminished in regions of glandular necrosis. In duodenal perforation, CT may reveal extraluminal air or fluid. CT findings of acute duodenal hemorrhage are duodenal wall thickening and a high-attenuation mass in the duodenal wall. In infection, the bile ducts can be dilated and also the attenuation from the bile could be increased at CT. Abscesses appear as hypoattenuating masses with enhancing capsules. CT findings of stent migration are an atypical location of the stent and bowel impaction. Other complications of ERCP are those associated with endoscopy and can include esophageal, liver, and splenic injury. So ERCP should must be performed by a very skilled gastroenterologists. With regards J S Chowhan |
If you have a surgical concern and can’t reach a doctor right away, or you’re not sure where else to ask a qualified laparoscopic surgeon, you can get our Medical Help through this Forum of World Laparoscopy Hospital which is available 24 hours a day, Just fill-up the form given and within few our the answer of your question will be posted on this forum. Please keep in mind we answer the question only related to laparoscopic surgery. You can also search and browse thousands of answer already posted on this forum
Using Free Medical Advice Related to Laparoscopic Surgery Service, you can send your questions to our Laparoscopic Surgeon and the Doctor will reply within few hour. It’s as if you are having an email exchange with your very own private surgeon! As soon as you post your question, a qualified laparoscopic surgeon will start answering it. Our expert can help you learn more about the treatment and procedure options available to you for different health problems and diseases.They’ll also give you information to discuss with your doctor when deciding what kind of surgical treatment is best for you.
The Doctor will provide you with the all the medical information you need, and will guide you as you choose a course of action, all from the comfort of your home or office. No more sitting in the waiting room for hours just to get some basic information from your laparoscopic surgeon; no more self-diagnosis after reading pages and pages of confusing and contradictory Online information.
World Laparoscopy Hospital gives you the personalized health information you need to decide on the right treatment for you. The information that you provide will be seen by every person for education and information purpose so please not write your real name.