Vol. 5, Issue 2, Part A (2021)

Author(s): Dr. B Santhi, Dr. Sugumar, Dr. Karthikeyan Sridevi, Dr. Uma, Dr. Ramprasath and Dr. Nandhini V

Abstract: A 47-year-old female presented with Easy fatigability, abdominal pain for 4 days. Past history of open cholecystectomy with Common bile duct exploration and Choledocho Duodenostomy done 13 years before. She later had multiple episodes of abdomen pain with fever on and off. ERCP revealed stone in common bile duct but not retrieved and patient lost follow-up. During this hospitalisation patient had fever, Jaundice and Sepsis with Acute Kidney Injury. Ultrasound Abdomen showed Hypoechoic lesion in seg IV left lobe liver. Mild pneumobilia. CECT Abdomen showed Pneumobilia, ill-defined hypodense lesions in segment IVA, II, III causing left lobe Intrahepatic biliary radicle dilation. MRCP showed Multiple tiny T2 hyperintense lesions with surrounding edema in SEGMENT IVB? Cholangitic abscess. Patient was taken up for surgery. Intraoperatively Left lateral segment II, III fibrotic, left hepatic duct & branches grossly dilated, stones retrieved from LHD; Left lateral sectionectomy, hepaticojejunostomy, jejunojejunostomy with access loop done. This was a rare case of recurrent pyogenic cholangiohepatitis managed surgically.