ABSTRACT
A 75-year-old male patient underwent endoscopic submucosal dissection (ESD) for early gastric cancer. The ESD ulcer bleeding occurred 7 days post-ESD, and he underwent endoscopic clipping hemostasis. Afterward, the patient presented with acute cholecystitis and cholangitis, thereby developing sclerosing cholangitis. His hepatic failure worsened and he died 15 months post-ESD although we performed endoscopic dilations for bile duct stenosis and administered antibiotics. We considered the condition to be related to secondary sclerosing cholangitis in critically ill patients (SSC-CIP) caused by bile duct ischemia and cholangitis.
Subject(s)
Cholangitis, Sclerosing , Cholangitis , Endoscopic Mucosal Resection , Hemostasis, Endoscopic , Stomach Neoplasms , Male , Humans , Aged , Cholangitis, Sclerosing/complications , Cholangitis, Sclerosing/surgery , Ulcer , Stomach Neoplasms/complicationsABSTRACT
A 64-year-old woman was prescribed lamivudine and adefovir (ADV) for chronic hepatitis B. Although her serum creatinine level was normal (<1.01 mg/dl), she developed bone pain due to Fanconi syndrome and osteomalacia. Therefore, ADV was discontinued and she was switched to entecavir (ETV); however, she developed an ETV-resistant mutant virus and a small dose of ADV was restarted. Her hepatitis B virus (HBV) -DNA levels and renal function were closely monitored. She has had preserved creatinine levels and tubular function, with almost undetectable HBV-DNA levels for more than a year after treatment.