| Gastroenterology Research, ISSN 1918-2805 print, 1918-2813 online, Open Access |
| Article copyright, the authors; Journal compilation copyright, Gastroenterol Res and Elmer Press Inc |
| Journal website http://www.gastrores.org |
Case Report
Volume 11, Number 1, February 2018, pages 58-61
Worsening of Acute Cholangitis Caused by a Bile Duct Stone After Hospitalization: A Case Series
Tables
| Case no. | Age/sex | Time to biliary drainage* | Severity of JG05 | Severity of JG13 | History of endoscopic treatment of cholangitis | Outcome |
|---|---|---|---|---|---|---|
| *Time from first visit to the start of endoscopic biliary drainage. JG05: 2005 Japanese Evidence-Based Clinical Practice Guidelines for the Management of Acute Cholangitis and Cholecystitis; JG13: revised edition of the JG05 published in 2013; EST: endoscopic sphincterotomy; M: male; F: female. Age is reported in years. | ||||||
| 1 | 82/M | Within 5 h | Moderate | Severe | None | Alive |
| 2 | 76/M | 5 to 24 h | Moderate | Moderate | None | Alive |
| 3 | 77/M | 5 to 24 h | Mild | Mild | EST | Dead |
| 4 | 71/M | 5 to 24 h | Moderate | Moderate | None | Alive |
| 5 | 57/M | Within 5 h | Moderate | Severe | None | Alive |
| 6 | 81/F | 5 to 24 h | Moderate | Mild | None | Alive |
| 7 | 78/F | Within 5 h | Mild | Mild | EST | Alive |
| 8 | 84/M | Within 5 h | Moderate | Mild | None | Alive |
| 9 | 72/M | 5 to 24 h | Moderate | Severe | None | Alive |
| 10 | 69/M | Within 5 h | Moderate | Severe | EST | Alive |
| 11 | 97/M | Within 5 h | Moderate | Moderate | None | Alive |
| Variable | Case 1 | Case 2 |
|---|---|---|
| WBC: white blood cell; RBC: red blood cell; Hb: hemoglobin; PLT: platelet; PT: prothrombin time; T-Bil: total bilirubin; AST: aspartate aminotransferase; ALT: alanine aminotransferase; LDH: lactate dehydrogenase; ALP: alkaline phosphatase; γ-GTP: γ-glutamyl transpeptidase; ALB: albumin; BUN: blood urea nitrogen; Cre: creatinine; AMY: amylase; CRP: C-reactive protein. | ||
| Peripheral blood | ||
| WBC, /µL | 8,600 | 14,000 |
| RBC, /µL | 427 × 104 | 454 × 104 |
| Hb, g/dL | 12.5 | 14.3 |
| Ht, % | 39.3 | 42 |
| PLT, /µL | 21.5 × 104 | 18.7 × 104 |
| Coagulation | ||
| PT, % | 95 | Not done |
| Biochemistry | ||
| T-Bil, mg/dL | 1.1 | 1.6 |
| AST, IU/L | 189 | 371 |
| ALT, IU/L | 59 | 149 |
| LDH, IU/L | 356 | 569 |
| ALP, IU/L | 355 | 732 |
| γ-GTP, IU/L | 198 | 412 |
| ALB, g/dL | 3.8 | 4.4 |
| BUN, mg/dL | 15 | 14 |
| Cre, mg/dL | 0.5 | 0.6 |
| AMY, IU/L | 112 | 125 |
| CRP, mg/dL | 0.04 | 0.1 |