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A 50-year-old patient with cholangitis 2 months after ERCP
Patient had a history of obstructive jaundice due to tumor CBD metastasis to liver before 4 months with stent that had been done in turkey 2 months ago. Now presented with fever, rigor jaundice, abdominal pain and poor appetite.
  • Her investigation: CBC was normal, ESR=90
  • T.S. Bilirubin 3.2, direct 2.4 alk phosphatase 580 IU/L.
  • INR=1
  • U/S showed a mass 1.2 cm x1 cm in RT lobe liver sub phrenic in location, large mass with necrotic competent extend to porta hepatis, dilated intra and till confluences, CBD not dilated and stent. with para aortic lymphadenopathy
  • Duodenscopy showed obstructed slipped stent for re stenting.
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