DOI: 10.12890/2021_002811
Fulminant Haemolysis Following Endoscopic Retrograde Cholangiopancreatography
Authors
mariob@campus.ul.pt
Keywords
Clostridium perfringens, haemolysis, spherocytosis, endoscopic retrograde cholangiopancreatography, sepsisAbstract
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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