J.Jpn. Surg. Soc.
ISSN 1880-1129

[Abstract] [Full Text PDF] （in Japanese / 2284KB） [Members Only And Two Factor Auth.]

J.Jpn. Surg. Soc.. 98(8): 713-716, 1997

Case report

A CASE OF SUDDEN ONSET OF TOXIC CHOLANGITIS

1) Department of Traumatology, Osaka University Medical School, Osaka, Japan
2) Senshu Critical Care Medical Center, Osaka, Japan

Kanabi Tanizaki1), Atsushi Hiraide1), Tetsuro Nishimura1), Hiroshi Sakae2), Toshiharu Yoshioka1), Hisashi Sugimoto1)

A previously healthy 43-year-old male was admitted to the hospital because of the impared consciouness. Although a passage of the bile duct was good, the patient was in severe biliary sepsis and cardiac arrest occurred repeatedly. Plasma concentration of TNF increased markedly suggesting a pathogenic role of TNF in the course of the patient. Plasma exchange was effective for hemodynamic stabilization. Recent advances in treatment of acute cholangitis has been brought by early drainage of the obstruction in the bile duct using endoscopic or percutaneous drainage. However this case suggests that only drainage of the infection focus is not sufficient for the life saving in such a patient and other therapeutic approach such as an inactivation of TNF activity should be considered.

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