Abstract
An 83-year-old women was admitted to our hospital because of a renal abscess, and she was given ceftriaxone for four weeks. After 36 days of admission, abdominal CT revealed high-density structures in the gallbladder and common bile duct (CBD) , which were not detected earlier. We diagnosed the abnormality as biliary pseudolithiasis caused by ceftriaxone and stopped ceftriaxone. A total of 144 days after diagnosis of pseudolithiasis, the patient complained of epigastralgia and high fever with elevated biliary enzyme levels. Abdominal CT once again revealed high-density structures in the gallbladder and CBD, and a diagnosis of CBD stones and cholangitis was made. Endoscopic sphincterotomy was performed for removal of the CBD stones, and laparoscopic cholecystectomy was subsequently performed. Typically, biliary pseudolithiasis has been reported to disappear a short time after discontinuing ceftriaxone. However, our case remained long-term, and caused biliary obstruction and colic pain.
