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CC BY-NC-ND 4.0 · Journal of Digestive Endoscopy 2020; 11(02): 163-164
DOI: 10.1055/s-0040-1709791
Case Report

Intrabiliary Acetylcysteine Infusion for Biliary Obstruction in a Case of Chronic Pancreatitis with Pancreatic Head IPMN

Paul K. Vincent
1   Department of Gastroenterology, Amrita Institute of Medical Sciences, Ponekkara, Cochin, Kerala, India
,
Hasim Ahamed
1   Department of Gastroenterology, Amrita Institute of Medical Sciences, Ponekkara, Cochin, Kerala, India
,
Rajesh Gopalakrishna 
1   Department of Gastroenterology, Amrita Institute of Medical Sciences, Ponekkara, Cochin, Kerala, India
,
Ramachandran Menon
1   Department of Gastroenterology, Amrita Institute of Medical Sciences, Ponekkara, Cochin, Kerala, India
,
Rama P. Venu
1   Department of Gastroenterology, Amrita Institute of Medical Sciences, Ponekkara, Cochin, Kerala, India
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Abstract

Successful biliary drainage in case of intraductal papillary mucinous neoplasm (IPMN) with thick mucus by ERCP and internal drainage alone is usually inadequate. The mucolytic properties of acetylcysteine can offer a therapeutic benefit in this setting. We report a 50-year-old man with chronic pancreatitis and IPMN who had recurrent episodes of biliary obstruction due to mucous occlusion, despite multiple stent exchanges. A nasobiliary catheter was placed and infusion of acetylcysteine was performed which resulted in significant improvement of jaundice. He later underwent surgery after nutritional rehabilitation. This case report highlights the role of intrabiliary acetylcysteine infusions for mucous occlusions in IPMN.

Keywords

acetylcysteine - cholangitis - IPMN - chronic pancreatitis


Publication History

Article published online:
03 July 2020

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