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Intravitreal Injection and Quantitation of Infection Parameters in a Mouse Model of Bacterial Endophthalmitis

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Published on: February 6, 2021

Refractory Choledocholithiasis Causing Endogenous Endophthalmitis: A Case Report.

Tadashi Tsukamoto¹, Chika Watanabe¹, Shintaro Kodai¹

¹Department of Hepatobiliary-Pancreatic Surgery, Osaka City General Hospital, Osaka, Japan.

The American Journal of Case Reports

|February 14, 2023

Summary

This summary is machine-generated.

Endogenous bacterial endophthalmitis, a rare complication of bile duct stones, can be effectively treated with Roux-en-Y choledochojejunostomy in intractable cases. This surgical bypass prevents recurrence of choledocholithiasis and associated infections like cholangitis and endophthalmitis.

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Area of Science:

Ophthalmology
Gastroenterology
Infectious Diseases

Background:

Endogenous bacterial endophthalmitis arises from pathogens breaching the blood-ocular barrier from distant infections.
Common bile duct stones causing cholangitis represent a rare but significant source of endogenous endophthalmitis.
Recurrent choledocholithiasis necessitates frequent endoscopic interventions, increasing complication risks.

Observation:

A 73-year-old male with diabetes experienced recurrent cholangitis due to bile duct stones, previously managed with endoscopic retrograde cholangiopancreatography (ERCP).
Following the latest ERCP, the patient developed endogenous bacterial endophthalmitis, requiring vitrectomy.
The patient relapsed with cholangitis and endophthalmitis, leading to surgical intervention.

Findings:

Roux-en-Y choledochojejunostomy was performed for intractable recurrent choledocholithiasis and cholangitis.
The surgical bypass successfully resolved the bile duct stones and associated cholangitis.
The patient remained free of choledocholithiasis, cholangitis, and endophthalmitis during a 5-year follow-up.

Implications:

Roux-en-Y choledochojejunostomy is a viable surgical option for managing complex, recurrent bile duct stone disease.
This procedure can prevent rare but severe complications such as endogenous bacterial endophthalmitis.
Early consideration of surgical bypass may be warranted in patients with frequent ERCP failures for choledocholithiasis.