CASE: BBS TYPE 2 ? PHB status PSRS 2008 & Open Chole in 1995^-www.drkeyurbhatt.in*

Saturday, May 21, 2011

CASE: BBS TYPE 2 ? PHB status PSRS 2008 & Open Chole in 1995^-www.drkeyurbhatt.in*

35 yrs female with h/o high spiking fever
In toxic cholangitis...
TLC : . 35K
with p/h/o open ccx in 1995 and massive bleeding at that time in Udaypur..
asymptomatic for 6-7 yrs
developed splenomegaly...and varices...and episode of cholangitis...
Diagnosed as PHB (Portal hypertensive biliopathy- due to EHPVO) Stented and PSRS Done in SIR GANGARAM HOSPITAL IN 2007.

later stent removed,

Again developed cholangitis 2- 3 episodes before this episode..
taken up for ERCP and with great difficulty GE physician could enter CBD Beyond stricture...and place 5 fr stent..which was draining pus

DIAGNOSIS: Portal hypertensive biliopathy ? Benign biliary stricture type 2. ( ischemic stricture following Open chole- bleeding...) status PSRS status Open cholecystectomy with cholangitis

ACTION: Stenting and relief from cholangitis...nutritional build up...
SURGERY: Open hepatico jejunostomy...