We present a rather unusual cause ofacute cholangitis occurrring in two very elderly patients.In both patients paravaterian diverticula was present. The paravaterian diverticula may cause cholangitis per se, without direct evidence of bile duct stones. The choice of a therapeutic approach in patients with complicated paravaterian diverticula should be based on the evolution of the clinical picture, as there are no guidelines addressing the management of this disease, especially in the very elderly. However, open-surgery of diverticula is currently limited to emergency surgery in the case of perforation or bleeding. ERCP with sphincterotomy is the technique of choice and is efficacious and safe also in the very old patients.
Paravaterian diverticula presenting as acute cholangitis in two very elderly patients.
ORLANDO, ROCCO;LIRUSSI, FLAVIO;
2010
Abstract
We present a rather unusual cause ofacute cholangitis occurrring in two very elderly patients.In both patients paravaterian diverticula was present. The paravaterian diverticula may cause cholangitis per se, without direct evidence of bile duct stones. The choice of a therapeutic approach in patients with complicated paravaterian diverticula should be based on the evolution of the clinical picture, as there are no guidelines addressing the management of this disease, especially in the very elderly. However, open-surgery of diverticula is currently limited to emergency surgery in the case of perforation or bleeding. ERCP with sphincterotomy is the technique of choice and is efficacious and safe also in the very old patients.
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