Internal and Emergency Medicine

, Volume 13, Issue 3, pp 367–371 | Cite as

ERCP or NO ERCP: the case report of a frail patient

  • Vincenzo Occhipinti
  • Simone Segato
  • Alberto Carrara
  • Stefania Orlando
  • Dario ConteEmail author

Case presentation

Occhipinti (clinical physician)

A 70-year-old man was admitted to the emergency department (ED) for a severe, continuous epigastric pain with back radiation and fever with chills, lasting 24 h.

His recent medical history was characterized by a long-term hospital stay (3.5 months) because of a severe acute necrotizing biliary pancreatitis (AP) complicated by acute respiratory distress syndrome (ARDS), which required invasive ventilation in the intensive care unit (ICU), and led to a septic shock secondary to the infection of two abdominal necrotic collections, dealt by an aggressive long-term antibiotic regimen that included levofloxacin (750 mg once a day, i.v.), piperacillin–tazobactam (4.5 g t.i.d, i.v.) and imipenem/cilastatin (500 q.i.d., i.v.) for a total of 1 month with concomitant placement of percutaneous drainages.

A CT scan carried out before the patient’s referral to a rehabilitation unit showed two residual fluid collections (66 and 55 mm in diameter,...


Compliance with ethical standards

Financial disclosure


Conflict of interest

The authors declare that they have no conflict of interest.

Human and animal rights

Authors indicate the procedures followed were in accordance with the ethical standards of the responsible committee on human experimentation (institutional and national).

Informed consent

Informed consent was obtained from the participant included in this case report.


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Copyright information

© SIMI 2017

Authors and Affiliations

  • Vincenzo Occhipinti
    • 1
  • Simone Segato
    • 1
  • Alberto Carrara
    • 2
  • Stefania Orlando
    • 1
  • Dario Conte
    • 1
    • 3
    Email author
  1. 1.Gastroenterology and Endoscopy UnitUniversità degli Studi MilanMilanItaly
  2. 2.General and Emergency SurgeryUniversità degli Studi MilanMilanItaly
  3. 3.Fondazione IRCCS Cà Granda, Ospedale Maggiore Policlinico MilanUniversità degli Studi MilanMilanItaly

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