Nakano H, Nakahara K, Michikawa Y, Suetani K, Morita R, Matsumoto N, Itoh F. Crowned dens syndrome developed after an endoscopic retrograde cholangiopancreatography procedure. World J Gastroenterol 2016; 22(39): 8849-8852 [PMID: 27818601 DOI: 10.3748/wjg.v22.i39.8849]
Corresponding Author of This Article
Hiroyasu Nakano, MD, Division of Gastroenterology and Hepatology, Department of Internal Medicine, St. Marianna University School of Medicine, 2-16-1, Sugao, Miyamae-ku, Kawasaki City, Kanagawa 216-8511, Japan. bluesky0314@gmail.com
Research Domain of This Article
Gastroenterology & Hepatology
Article-Type of This Article
Case Report
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Hiroyasu Nakano, Kazunari Nakahara, Yosuke Michikawa, Keigo Suetani, Ryo Morita, Nobuyuki Matsumoto, Fumio Itoh, Division of Gastroenterology and Hepatology, Department of Internal Medicine, St. Marianna University School of Medicine, Kanagawa 216-8511, Japan
Author contributions: Nakano H, Nakahara K and Matsumoto N designed the report; Nakano H, Nakahara K, Michikawa Y, Suetani K and Morita R were attending doctors for the patient; Itoh F organized the report; and Nakano H wrote the paper.
Informed consent statement: Written informed consent for endoscopic intervention was obtained from the patient and patient’s families.
Conflict-of-interest statement: Authors have no conflict of interest.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Hiroyasu Nakano, MD, Division of Gastroenterology and Hepatology, Department of Internal Medicine, St. Marianna University School of Medicine, 2-16-1, Sugao, Miyamae-ku, Kawasaki City, Kanagawa 216-8511, Japan. bluesky0314@gmail.com
Telephone: +81-44-9778111 Fax: +81-44-9765805
Received: April 4, 2016 Peer-review started: April 4, 2016 First decision: May 12, 2016 Revised: May 26, 2016 Accepted: July 20, 2016 Article in press: July 20, 2016 Published online: October 21, 2016
Abstract
We present a unique case of crowned dens syndrome (CDS) that developed after endoscopic retrograde cholangiopancreatography (ERCP) in a patient who presented with fever and neck pain. Administration of non-steroidal anti-inflammatory drugs was extremely effective for relieving fever and neck pain, and in the improvement of inflammatory markers. To the best of our knowledge, this is the first case report of CDS caused by an ERCP procedure. In a patient with fever and neck pain after an ERCP procedure, CDS should be considered in the differential diagnosis.
Core tip: There are numerous differential diagnoses for patients with fever after an endoscopic retrograde cholangiopancreatography (ERCP). A careful evaluation of medical history and a physical examination provide clues to making a definitive diagnosis. Retrograde cholangitis is a well-known complication of ERCP; additionally, pseudogout is known to develop after severe illnesses or surgery. This case report describes a patient with pseudogout of the neck, which is also known as crowned dens syndrome (CDS). CDS should be considered in a patient with fever and neck pain after an ERCP procedure.
