Abstract
A 60-year-old woman who had been diagnosed as having cholelithiasis for over 15 years suffered sudden jaundice. We performed ERCP and found a dilated common bile duct, incomplete obstruction and irregularity of lower CBD, dilatation of the intrahepatic bile tree and multiple liver abscesses. The pathogenesis of obstruction was thought to be bile duct cancer, however, the bile obtained by PTCD was purulent. Thus, it is necessary to discuss differential diagnoses and therapy for acute suppurative cholangitis and acute obstructive suppurative cholangitis.