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Ascending Cholangitis due to Heavy Lifting
1Department of Internal Medicine, Zaans Medisch Centrum, Zaandam, the Netherlands.
Case Reports in Gastroenterology
|October 17, 2017
Summary
Gallstone disease commonly causes cholangitis. This case report details recurring cholangitis in a patient with a clear bile duct, suggesting duodenal reflux from heavy lifting as a potential cause after prior papillotomy.
Area of Science:
- Gastroenterology and Hepatology
- Biliary System Pathophysiology
Background:
- Gallstone disease is a primary risk factor for cholangitis.
- Cholangitis typically requires the presence of gallstones in an anatomically normal bile duct.
- Endoscopic retrograde cholangiography with papillotomy and stone extraction is a standard treatment for common bile duct stones.
Observation:
- A 73-year-old male presented with recurrent cholangitis.
- The patient had a history of prior papillotomy.
- The bile duct system was found to be clear of stones.
Findings:
- Recurrent cholangitis occurred despite the absence of gallstones.
- The patient's bile duct system was anatomically normal.
- A proposed etiology involves duodenal reflux into the common bile duct.
Implications:
- This case highlights potential non-stone-related causes of cholangitis.
- Duodenal reflux, possibly triggered by physical exertion like heavy lifting, may lead to recurrent cholangitis.
- Further investigation into reflux-induced cholangitis is warranted.
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