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Case Report
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| Management of impacted common bile duct stones in late stage pregnancy and immediately post-partum after failed endoscopic stone extraction |
| Omar K Danner1, Omosalewa Akinyemi2, Kenneth L Wilson1, Moses Owoso3, L Ray Matthews1 |
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1Assistant Professor of Surgery, Morehouse School of Medicine, 720 Westview Dr. S.W. Atlanta, GA 30310, USA.
2PGY-II, Morehouse School of Medicine, 720 Westview Dr. S.W. Atlanta, GA 30310, USA. 3Assistant Professor of Surgery, Meharry School of Medicine, 720 Westview Dr. S.W. Atlanta, GA 30310, USA |
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doi:10.5348/ijcri-2011-11-66-CR-4
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Address correspondence to: L. Ray Matthews Morehouse School of Medicine Department of Surgery 720 Westview Dr. S.W. Atlanta GA 30310 USA. Phone: (404)616-1415 Fax: (404)616-1417 Email: odanner@msm.edu |
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| How to cite this article: |
| Danner OK, Akinyemi O, Wilson KL, Owoso M, Matthews LR. Management of impacted common bile duct stones in late stage pregnancy and immediately post-partum after failed endoscopic stone extraction. International Journal of Case Reports and Images 2011;2(11):14-17. |
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Abstract
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Introduction:
Symptomatic gallstone disease is the second most common abdominal emergency in pregnant women after acute appendicitis. Extrahepatic biliary obstruction by gallstones during pregnancy remains one of the most challenging management problems in the field of surgery. Although there have been many advancements in the surgical and endoscopic management of gallstone disease, the risks of these interventions and anesthesia to the developing fetus still prevents their routine application during the gestational period. Traditionally, these types of disorders during pregnancy are managed conservatively or via appropriately timed cholecystectomy. However, when the late-term pregnant patient presents acutely with evidence of biliary tract obstruction and sepsis, it represents a medical or surgical emergency.
Case Report: We present the case management of a 25-year-old late term pregnant female with an impacted common bile duct stone and impending biliary sepsis as a result of failed postpartum endoscopic stone extraction. Conclusion: Due to the risk of potential harm to the fetus, this patient subset must be managed in clinically sound and technically proficient manner, which does not allow time for conservative management. Consequently, appropriate management algorithms for conservative therapy versus endoscopic or surgical interventions need to be clearly outlined and defined. | |
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Key Words:
Management, Post-Partum, Stones
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Author Contributions:
Omar K Danner - Substantial contributions to conception and design, Acquisition of data, Analysis and interpretation of data, Drafting the article, Final approval of the version to be published Omosalewa Akinyemi - Acquisition of data, Drafting the article, Final approval of the version to be published Kenneth L Wilson - Substantial contributions to conception and design, Revising it critically for important intellectual content, Final approval of the version to be published Moses Owoso - Analysis and interpretation of data, Revising it critically for important intellectual content, Final approval of the version to be published L Ray Matthews - Analysis and interpretation of data, Revising it critically for important intellectual content, Final approval of the version to be published |
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Guarantor of submission:
The corresponding author is the guarantor of submission. |
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Source of support:
None |
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Conflict of interest:
Authors declare no conflict of interest. |
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Copyright:
© Danner et al. 2011; This article is distributed the terms of Creative Commons Attribution License which permits unrestricted use, distribution and reproduction in any means provided the original authors and original publisher are properly credited. (Please see Copyright Policy for more information.) |
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