Acute obstructive suppurative cholangitis in a man with an enlarged inferior pancreaticoduodenal lymphnode

A case report of a 55-year-old male, who was seen with epigastric pain and hyperamylasemia, is to be presented. He failed to respond to the intensive antibiotic therapy, and subsequently acute obstructive suppurative cholangitis fully developed. At laparotomy, an inflammatory enlarged inferior pancreaticoduodenal lymphnode, which apparently compressed the common bile duct, was found. To our knowledge, no prior case of acute obstructive suppurative cholangitis provoked by an enlarged lymphnode has been reported. A plea is made for attention to lymphnodes involved by inflammatory or neoplastic disorders, as well as common provoking agents such as calculi.