Open Access�White bile� as a result of a malignant bile obstruction
Author(s) -
Sara Pérez Moyano,
César Arranz Solana,
Lorena Morillo Blanco,
Julio Guilarte López-Mañas
Publication year - 2021
Publication title -
revista española de enfermedades digestivas/revista española de enfermedades digestivas
Language(s) - English
Resource type - Journals
eISSN - 2340-4167
pISSN - 1130-0108
DOI - 10.17235/reed.2021.8098/2021
Subject(s) - medicine , major duodenal papilla , endoscopic retrograde cholangiopancreatography , bile duct , cholangiography , gastroenterology , common bile duct , fistulotomy , bilirubin , cholestasis , jaundice , obstructive jaundice , bile duct diseases , radiology , pancreatitis , fistula , anal fistula
An 87-year-old female was admitted for endoscopic retrograde cholangiopancreatography (ERCP) due to obstructive jaundice. On admission, total bilirubin was 15 mg/dl at the expense of direct bilirubin, GOT 356 U/l mg/dl, GPT 174 U/l, FA 2,358 U/l and GGT 1,089 U/l. The ERCP showed a prominent, irregular, non-cannulable papilla, so a fistulotomy was performed, emitting a clear, non-mucous fluid. Biliary localization was verified after inserting the guidewire. Cholangiography showed dilatation of the intra-extra hepatic bile duct (common bile duct 18-20 mm). An uncoated metal prosthesis was implanted and a biopsy was performed, confirming papillary adenocarcinoma.