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PubMed1997

Bleeding causing biliary obstruction after endoscopic sphincterotomy.

A 68-yr-old woman who had had a cholecystectomy and endoscopic sphincterotomy developed recurrent common bile duct obstruction. She had another ERCP with extension of the site of endoscopic sphincterotomy, and 3 days later biliary obstruction again developed, this time from a blood clot filling the common bile duct. The clot was removed by Fogarty technique, and the duct was irrigated with heparin; the obstruction resolved. Minor hemobilia (biliary tract hemorrhage without overt GI bleeding) may be confused with choledocholithiasis. When biliary obstruction follows endoscopic sphincterotomy, attempts at flushing the duct should precede empiric maneuvers for stone removal.

Aged↗

PubMed1995

Infectious colitides in patients with acquired immunodeficiency syndrome.

Diarrhea is a common problem in patients with acquired immunodeficiency syndrome (AIDS), and infections of the colon constitute a significant etiology. Cytomegalovirus (CMV) is the most common opportunistic infection of the colon in patients with AIDS, and it can involve any portion of the colon and the gastrointestinal tract. Because CMV is potentially treatable with either ganciclovir or foscarnet, it is important to evaluate endoscopically the entire colon of patients with AIDS with protracted diarrhea and no cause identifiable with routine stool and laboratory tests. In addition to CMV, there are a variety of other viral, bacterial, protozoal, and fungal infections seen in patients with AIDS. A thorough evaluation will help identify these pathogens, and those that are treatable can be given appropriate therapy.

AIDS-Related Opportunistic Infections↗