Korean J Gastroenterol.  2013 Dec;62(6):379-381. 10.4166/kjg.2013.62.6.379.

Acute Gallstone Pancreatitis Misdiagnosed as Acupuncture Induced Traumatic Pancreatitis

• Hwang ET
• Cho JH

• KMID: 1711296
• DOI: http://doi.org/10.4166/kjg.2013.62.6.379

Abstract

No abstract available.

MeSH Terms

Acupuncture Therapy/adverse effects
Acute Disease
Cholangiopancreatography, Endoscopic Retrograde
Common Bile Duct/surgery/ultrasonography
Diagnostic Errors
Female
Gallstones/*diagnosis/surgery
Humans
Middle Aged
Pancreatitis/*diagnosis
Tomography, X-Ray Computed

Figure

• 

  Fig. 1. Initial abdominal CT scan. (A) Entrapped free air between stomach and pancreas is seen on axial scan, along with (B) edematous change of duodenal wall and swelling of pancreatic head with peripancreatic inflammation. (C) Mildly dilated common bile duct without stone and localized mesenteric infiltrations and haziness can also be observed.

• 

  Fig. 2. Abdominal CT scan taken 12 days after admission. (A) Pancreatic head swelling is more aggravated, but (B) duodenal wall edema and mesenteric infiltrations have improved.

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  Fig. 3. Endoscopic ultrasonography. (A) Common bile duct stone (maximum diameter: 4.2 mm) and (B) multiple small gallbladder stones can be visualized.

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  Fig. 4. Endoscopic retrograde cholangiopancreatography. (A) Multiple stones are seen in the common bile duct, (B) which proved to be yellowish cholesterol stones upon extraction by basket.

Reference

References

1. van Geenen EJ, van der Peet DL, Bhagirath P, Mulder CJ, Bruno MJ. Etiology and diagnosis of acute biliary pancreatitis. Nat Rev Gastroenterol Hepatol. 2010; 7:495–502.

2. Forsmark CE, Baillie J. AGA Institute Clinical Practice and Economics Committee; AGA Institute Governing Board. AGA Institute technical review on acute pancreatitis. Gastroenterology. 2007; 132:2022–2044.

3. Uhm MS, Kim YS, Suh SC, et al. Acute pancreatitis induced by traditional acupuncture therapy. Eur J Gastroenterol Hepatol. 2005; 17:675–677.

4. Puri R, Vilmann P. Endoscopic ultrasound scanning in gallstone disease. Scand J Gastroenterol. 2006; 41:1369–1381.

5. Alexakis N, Lombard M, Raraty M, et al. When is pancreatitis considered to be of biliary origin and what are the implications for management? Pancreatology. 2007; 7:131–141.

6. Cho JH, Jeon TJ, Choi JS, et al. EUS finding of geographic hyperechoic area is an early predictor for severe acute pancreatitis. Pancreatology. 2012; 12:495–501.