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Case Reports in Medicine
Volume 2017 (2017), Article ID 3835825, 5 pages
Case Report

Usefulness of Endoscopic Managements in Patients with Ceftriaxone-Induced Pseudolithiasis Causing Biliary Obstruction

1Department of Internal Medicine, Munakata Medical Association Hospital, Fukuoka, Japan
2Department of Surgery, Munakata Medical Association Hospital, Fukuoka, Japan
3Department of Nephrology, Munakata Medical Association Hospital, Fukuoka, Japan

Correspondence should be addressed to Yasuhiro Doi

Received 10 July 2017; Accepted 25 September 2017; Published 2 November 2017

Academic Editor: William B. Silverman

Copyright © 2017 Yasuhiro Doi et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


Ceftriaxone (CTRX) is known to cause reversible biliary stones/sludge, which is called biliary pseudolithiasis. We report two rare cases of biliary obstruction by pseudolithiasis shortly after completing CTRX treatment. Stones and sludge, which had not been detected before CTRX administration, appeared in the gallbladder and common bile duct and led to biliary obstruction and acute cholangitis. The obstructions were successfully treated with endoscopic retrograde biliary drainage and endoscopic sphincterotomy. CTRX-induced biliary pseudolithiasis has been reported mainly in children and adolescents but is also seen in adults with similar incidence rate. Although CTRX-induced biliary pseudolithiasis is usually asymptomatic and disappears spontaneously after discontinuing the drug, some patients develop biliary obstruction. Endoscopic managements should be considered in such cases.