Case Report
Copyright ©2007 Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Dec 14, 2007; 13(46): 6277-6280
Published online Dec 14, 2007. doi: 10.3748/wjg.v13.i46.6277
Prolonged cholestasis following successful removal of common bile duct stones: Beware patients on estrogen therapy
JM Dunn, A McNair
JM Dunn, A McNair, The Queen Elizabeth Hospital, Woolwich, London, United Kingdom
Author contributions: All authors contributed equally to the work.
Correspondence to: A McNair, Gastroenterology Department, The Queen Elizabeth Hospital, Stadium Road, Woolwich, London, SE18 4QH, United Kingdom.
Telephone: +44-8-8365579 Fax: +44-8-8365581
Received: May 8, 2007
Revised: August 24, 2007
Accepted: August 31, 2007
Published online: December 14, 2007

There are various well described forms of chronic cholestatic jaundice in adults, such as autoimmune cholangitis, drug-induced cholangitis and intrahepatic cholestasis of pregnancy. We present two cases of prolonged cholestasis following removal of gallstones at endoscopic retrograde cholangiopancreatography (ERCP) and subsequent clear cholangiography. Both patients were taking oral estrogens at the time of presentation, which were subsequently withdrawn. The first case responded rapidly to corticosteroid treatment, and the second case had a much slower resolution with ursodeoxycholic acid. Both cases highlighted the significance of estrogen-induced cholestasis in female patients with protracted jaundice following ERCP and removal of intra-ductal stones. After oral estrogens are discontinued, a short course of steroids needs to be considered.

Keywords: Estrogen, Cholestasis, Gallstones, Steroids, Ursodeoxycholic acid