An unusual Case of Obstructive Jaundice with an ambiguous stone Complicated by Disseminated Intravascular Coagulation and Acute Kidney Injury: A Multifaceted Approach to Management

An unusual Case of Obstructive Jaundice with an ambiguous stone Complicated by Disseminated Intravascular Coagulation and Acute Kidney Injury: A Multifaceted Approach to Management

Authors

  • Tayyab Abbas Fatima Memorial Hospital, Shadman, Lahore, Pakistan
  • Muhammad Kamran Rauf Fatima Memorial Hospital, Shadman, Lahore, Pakistan
  • Hafiza Javeria Shaheen Fatima Memorial Hospital, Shadman, Lahore, Pakistan
  • Sidra Anwar Fatima Memorial Hospital, Shadman, Lahore, Pakistan

DOI:

https://doi.org/10.21649/akemu.v31i1.5766

Keywords:

Obstructive jaundice, Disseminated intravascular coagulation, Acute kidney injury, ERCP, Stent placement

Abstract

A 40-year-old man presented with obstructive jaundice complicated by DIC and AKI, highlighting the challenges in diagnosis and management. Obstructive jaundice can present with a spectrum of complications, including DIC and AKI, which significantly impact patient management and outcomes. Prompt recognition and intervention are crucial in such cases. ERCP with stent placement is an effective therapeutic modality for relieving biliary obstruction. Close monitoring and multidisciplinary management involving hepatologists, nephrologists, and intensivists are essential for optimizing patient care.

References

1. Chen HL, Wu SH, Hsu SH, Liou BY, Chen HL, Chang MH. Jaundice revisited: recent advances in the diagnosis and treatment of inherited cholestatic liver diseases. J Biomed Sci. 2018;25(1):75. doi:10.1186/s12929-018-0475-8.

2. Sokal A, Sauvanet A, Fantin B, de Lastours V. Acute cholangitis: diagnosis and management. J Visc Surg. 2019;156(6):515-25. doi:10.1016/j.jviscsurg.2019.05.007.

3. Xiang L, Li J, Liu D, Yan L, Zeng H, Liu Y. Safety and feasibility of primary closure following laparoscopic common bile duct exploration for treatment of choledocholithiasis. World J Surg. 2023;47(4):1023-30. doi:10.1007/s00268-022-06871-9.

4. Costello RA, Leslie SW, Nehring SM. Disseminated intravascular coagulation. Treasure Island (FL): StatPearls Publishing; 2024 [internet]. [cited 2025 Apr 3]. Available from: https://www.ncbi.nlm.nih.gov/books/NBK441834. PMID: 28722864.

5. Shin J, Oh CH, Dong SH. Single-operator cholangioscopy guided lithotripsy. Korean J Gastroenterol. 2022;80(4):163-8. doi:10.4166/kjg.2022.117.

6. Yang R, Zhu S, Pischke SE, Haugaa H, Zou X, Tonnessen TI. Bile and circulating HMGB1 contributes to systemic inflammation in obstructive jaundice. J Surg Res. 2018; 228(1):14-9. doi: 10.1016/j.jss.2018.02.049.

7. Park CH. The management of common bile duct stones. Korean J Gastroenterol. 2018;71(5):260-3. doi:10.4166/kjg.2018.71.5.260.

8. Angsuwatcharakon P, Rerknimitr R. Cracking difficult biliary stones. Clin Endosc. 2021;54(5):660-8. doi: 10.5946/ce.2020.256-IDEN. Epub 2021 Mar 16.

9. Lesmana CRA, Paramitha MS, Lesmana LA. Innovation of endoscopic management in difficult common bile duct stone in the era of laparoscopic surgery. World J Gastrointest Endosc. 2021;13(7):198-209. doi:10.4253/wjge.v13.i7.198.

10. Tringali A, Costa D, Fugazza A, Colombo M, Khalaf K, Repici A, et al. Endoscopic management of difficult common bile duct stones: Where are we now? A comprehensive review. World J Gastroenterol. 2021;27(44):7597-611. doi:10.3748/wjg.v27.i44.7597.

11. Chawla LS, Bellomo R, Bihorac A, Goldstein SL, Siew ED, Bagshaw SM, et al. Acute kidney disease and renal recovery: consensus report of the Acute Disease Quality Initiative (ADQI) 16 Workgroup. Nat Rev Nephrol. 2017;13(4):241-257. doi: 10.1038/nrneph.2017.2. Epub 2017 Feb 27. PMID: 28239173.

Downloads

Published

03/31/2025

How to Cite

Tayyab Abbas, Muhammad Kamran Rauf, Hafiza Javeria Shaheen, & Anwar, S. (2025). An unusual Case of Obstructive Jaundice with an ambiguous stone Complicated by Disseminated Intravascular Coagulation and Acute Kidney Injury: A Multifaceted Approach to Management. Annals of King Edward Medical University, 31(1). https://doi.org/10.21649/akemu.v31i1.5766

Issue

Section

Case Reports

Similar Articles

> >> 

You may also start an advanced similarity search for this article.

Loading...