ERCP & BILIARY STONE EXTRACTION ON 25-JUNE-2014 52 years old Gul Khan,referred to AREC/LIVER CLINIC, by a well known Gastroenterologist Dr Tayyab Hussnain from Sargodha. His s/bil was 1.6, ALT=128, Alk PO4=1357. Ultrasound showing dilated CBD &IHBCs, but no stone. During ERCP, the ampulla was found displaced distally due to a large duodenal diverticulum, however normal in shape. After cannulation, guide-wire passed into the CBD, & then, the contrast was injected. The CBD as well as intrahepatic ducts were dilated. The cannulation was difficult due to distal CBD stone as well as ampullary stenosis. The CBD contained two small stones as well as sludge. The pancreatic duct was normal. Ample sphincterotomy followed by balloon trawling resulted evacuation of sludge as well as small stones, after which free flow of bile seen. Plan given to pt: Repeat CBC, LFTs & Ultrasound after 2 weeks & follow. DR. MUHAMMAD IRFAN Assistant Professor of Medicine Endoscopist/ERCP Consultant
Posted on: Fri, 04 Jul 2014 00:18:14 +0000