Acute Gallstone Pancreatitis Misdiagnosed as Acupuncture Induced Traumatic Pancreatitis

Eui Tae Hwang; Jae Hee Cho

doi:10.4166/kjg.2013.62.6.379

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Hwang and Cho: Acute Gallstone Pancreatitis Misdiagnosed as Acupuncture Induced Traumatic Pancreatitis

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Korean J Gastroenterol 2013;62(6):379-381.

Published online: 4 October 2013

DOI: https://doi.org/10.4166/kjg.2013.62.6.379

Acute Gallstone Pancreatitis Misdiagnosed as Acupuncture Induced Traumatic Pancreatitis

Eui Tae Hwang, Jae Hee Cho¹

Division of Gastroenterology, Department of Internal Medicine, Myongji Hospital, Goyang, Korea

¹Gachon University Gil Medical Center, Incheon, Korea

Correspondence to: Jae Hee Cho, Division of Gastroenterology, Department of Internal Medicine, Gachon University Gil Medical Center, 21 Namdong-daero 774beon- gil, Namdong-gu, Incheon 405-760, Korea. Tel: +82-32-460-3778, Fax: +82-32-460-3408, E-mail: jhcho9328@gmail.com

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

References

1. van Geenen EJ, van der Peet DL, Bhagirath P, Mulder CJ, Bruno MJ. Etiology and diagnosis of acute biliary pancreatitis. Nat Rev Gastroenterol Hepatol. 2010; 7:495–502.

2. Forsmark CE, Baillie J. AGA Institute Clinical Practice and Economics Committee; AGA Institute Governing Board. AGA Institute technical review on acute pancreatitis. Gastroenterology. 2007; 132:2022–2044.

3. Uhm MS, Kim YS, Suh SC, et al. Acute pancreatitis induced by traditional acupuncture therapy. Eur J Gastroenterol Hepatol. 2005; 17:675–677.

4. Puri R, Vilmann P. Endoscopic ultrasound scanning in gallstone disease. Scand J Gastroenterol. 2006; 41:1369–1381.

5. Alexakis N, Lombard M, Raraty M, et al. When is pancreatitis considered to be of biliary origin and what are the implications for management? Pancreatology. 2007; 7:131–141.

6. Cho JH, Jeon TJ, Choi JS, et al. EUS finding of geographic hyperechoic area is an early predictor for severe acute pancreatitis. Pancreatology. 2012; 12:495–501.

Fig. 1.

Initial abdominal CT scan. (A) Entrapped free air between stomach and pancreas is seen on axial scan, along with (B) edematous change of duodenal wall and swelling of pancreatic head with peripancreatic inflammation. (C) Mildly dilated common bile duct without stone and localized mesenteric infiltrations and haziness can also be observed.

Fig. 2.

Abdominal CT scan taken 12 days after admission. (A) Pancreatic head swelling is more aggravated, but (B) duodenal wall edema and mesenteric infiltrations have improved.

Fig. 3.

Endoscopic ultrasonography. (A) Common bile duct stone (maximum diameter: 4.2 mm) and (B) multiple small gallbladder stones can be visualized.

Fig. 4.

Endoscopic retrograde cholangiopancreatography. (A) Multiple stones are seen in the common bile duct, (B) which proved to be yellowish cholesterol stones upon extraction by basket.

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