Atlas of Gastroenterological Endoscopy
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Cholangitis
Purulent cholangitis ERCP was performed for acute obstructive jaandice secondary to biliary duct stones. After sphincterotomy pus leaves the biliary duct. Threads of pus are seen cranial to catheter. In acute cholangitis without ductal stones primary ERCP is contraindicated, because of fear of germ ascension into the liver. In case of choledocholithiasis, the stones can trigger the inflammation. Thus stone extraction is mandatory.
Purulent cholangitis Obstructive cholestasis and fever gave the initiative to examination. Without prior manipulation purulent liqiud leaks spontaneously from the orifice.