Fulminant Haemolysis Following Endoscopic Retrograde Cholangiopancreatography

  • Mário Bibi Internal Medicine Department, Hospital Pedro Hispano, Porto, Portugal
  • Susana Viana Internal Medicine Department, Hospital Pedro Hispano, Porto, Portugal
  • Cátia Leitão Gastroenterology Department, Hospital Pedro Hispano, Porto, Portugal
  • Rui Moço Internal Medicine Department, Hospital Pedro Hispano, Porto, Portugal
  • Yuliana O. Eremina Clinical Pathology Department, Hospital Pedro Hispano, Porto, Portugal; EPIUnit, Instituto de Saúde Pública, Universidade do Porto, Porto, Portugal

Keywords

Clostridium perfringens, haemolysis, spherocytosis, endoscopic retrograde cholangiopancreatography, sepsis

Abstract

We report the case of a 77-year-old-man with a history of type 2 diabetes mellitus who underwent endoscopic retrograde cholangiopancreatography (ERCP) because of a gallstone in the common bile duct. Thirty-six hours after the procedure, the patient developed persistent fever and epigastric pain associated with de novo jaundice. Massive haemolysis (with exuberant spherocytosis) occurred and patient died in 3 hours. Clostridium perfringens was isolated in the blood cultures. Massive haemolysis associated with C. perfringens has a high mortality rate. Management involves a high index of suspicion after gastrointestinal procedures like ERCP, surgical consultation, antibiotic therapy, transfusion of red cell concentrates and, potentially, hyperbaric oxygen therapy.

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  • Published: 2021-10-08

    Issue: 2021: Vol 8 No 9 (view)

    Section: Articles

    How to cite:
    1.
    Bibi M, Viana S, Leitão C, Moço R, Eremina YO. Fulminant Haemolysis Following Endoscopic Retrograde Cholangiopancreatography. EJCRIM 2021;8 doi:10.12890/2021_002811.

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