2019 Volume 33 Issue 2 Pages 250-254
A 79-year-old man developed an epigastric pain and a fever during his hospitalization for acute exacerbation of chronic heart failure. Increased hepatobiliary enzyme level and inflammatory reaction were observed. A hyperdense area was detected in the gallbladder and distal bile duct on abdominal computed tomography (CT). Under the diagnosis of acute obstructive chalangitis, endoscopic nasobiliary drainage was conducted. At a later date, dissipation of the hyperdense area in the distal bile duct was observed on abdominal CT. High concentrations of amiodarone and its metabolite in the bile were believed to cause obstructive jaundice. Owing to the necessity of continuous internal administration, endoscopic papillotomy (EST) was conducted for the patient. Subsequently, no recurrence of the obstructive jaundice and acute cholangitis were observed. As no case of obstructive jaundice and acute cholangitis caused by amiodarone administration has been reported in Japan and EST is believed to be useful for the prevention of the recurrences of the aforementioned conditions, we report the outcomes of our case herein.
