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
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.
Obstructive cholestasis and fever gave the initiative to examination. Without
prior manipulation purulent liqiud leaks spontaneously from the orifice.