Acute suppurative cholangitis

keywords:, Acute suppurative cholangitis, common bile duct, ERCP, cholangiogram, ,stent. A 38yearold lactating woman presented with severe epigastric pain that is referred to the back was admitted to the endoscopy unit. Abdominal ultrasound revealed gall bladder stones, diagnosed 4 years ago and dilated CBD with a stone in its lumen. Laboratory investigations showed leukocytosis, white blood cell count 12. 4 103, normal range ), international normalized ratio 1, 32 (normal range 11. 7 ), alanine aminotransferase 233, (normal up to 40 IU, L ), aspartate aminotransferase 398, (normal up to 40 IU, L ), lipase 40( normal below 60U, L ). The patient underwent endoscopic retrograde cholangiopancreatography. The scope revealed normally located papilla. Cannulation was done using an ERCP cannula, a cholangiogram revealed mildly dilated CBD. A wide sphincterotomy was done. The scope also showed an excessive amount of pus, whitish color coming out from the papilla denoting, acute suppurative