Endoscopic Retrograde Cholangiopancreatography Management of Choledocholithiasis, Acute Cholangitis and Acute biliary Pancreatitis in a Patient with Sickle Cell Disease: A Case Report

Abstract

Acute cholangitis is a life-threatening condition caused by an ascending bacterial infection of biliary tree. Choledocholithiasis is the most common cause of ascending cholangitis. It can be caused by either primary or secondary bile duct stones. Obstruction of the pancreatic outlet due to migration of bile duct stones trigger the pathophysiological mechanisms of acute biliary pancreatitis, such as intracellular enzyme activation, self-digestion, and activation of the inflammatory pathway. Sickle cell diseasepatients, due to hemolysis, are at high risk of development of pigmented gallstones. Development of primary choledocholithiasis in Sickle cell disease is very uncommon. Cholangitis if not timely managed can be fatal. Here, we report on a case of Sickle cell disease patients presenting with acute cholangitis and acute biliary pancreatitis which was successfully managed by Endoscopic Retrograde Cholangiopancreatography (ERCP).