Korean J Gastrointest Endosc.  1994 Sep;14(3):380-385.

A Case of Large Bile Duct Stones Complicated by Pyogenic Pericarditis, Liver Abscess, and Pyothorax

• Choi HS
• Park KS
• Choi DR
• Kho JH
• Choi WS
• Ahn JH
• Cho BS
• Park BS

Abstract

The complications of bile duct stone are cholangitis, pancreatitis, obstructive jaundice, liver abscess, and secondary biliary cirrhosis. Liver abscess may produce pyothorax, peritonitis, subphrenic abscess, and pyogenic pericarditis. The case studies of pyogenic pericarditis secondary to pyogenic liver abscess are rarely reported. Stones greater than 20mm in diameter are difficult or impossible to remove with a standard basket or balloon after sphincterotomy. There are several nonsurgical treatment options for large bile duct stone: mechanical lithotripsy, endoprosthesis, extracorporeal shock-wave lithotripsy (ESWL), electrohydraulic lithotripsy, contact dissolution therapy, and laser lithotripsy. We experienced a case of large bile duct stone which complicated by pyogenic pericarditis, liver abscess, and pyothorax. He treated with antibiotics, closed thoracostomy, partial pericardiectomy, and removal of bile duct stones by extracorporeal shock-wave and mechanical lithotripsy after endoscopic sphincterotomy and nasobiliary drainage.

Keyword

Pyogenic pericarditis; Liver abscess; Empyema; Complication; Large bile duct stone

MeSH Terms

Anti-Bacterial Agents
Bile Ducts*
Bile*
Cholangitis
Drainage
Empyema
Empyema, Pleural*
Jaundice, Obstructive
Lithotripsy
Lithotripsy, Laser
Liver Abscess*
Liver Abscess, Pyogenic
Liver Cirrhosis, Biliary
Liver*
Pancreatitis
Pericardiectomy
Pericarditis*
Peritonitis
Sphincterotomy, Endoscopic
Subphrenic Abscess
Thoracostomy
Anti-Bacterial Agents