A 35-year-old and 28-week-old secundigesta presented to the Obstetrics Emergency Department complaining of colic abdominal pain in the epigastric region radiating to the lumbar fossae.
The obstetric examination is normal, the patient is defended afflicted and the abdominal examination shows pain to palpation in the epigastric region without peritoneal irritation, the hemogram is normal as well as urine analysis.
Pain is not usually managed with analgesia and is therefore admitted for monitoring.
On the fourth day, pain improved and subconjunctival jaundice and choluria appeared, as well as micropapular and erythematous pruritic skin lesions.
The blood count remains normal, with abnormal liver function tests with a characteristic pattern of cholestasis.
Abdominal ultrasound showed a liver of normal size, gallbladder with lithiasis and biliary tract slightly with a calculus in distal bile duct and normal pancreas.
With the objective of identifying biliary strictures that are easy to perform in a multidisciplinary approach and after a session and the patient's consent, it was decided to perform therapeutic CP with sedation, prior maturation of the fetal lung and a 2-second cannula.
Complete sphincterotomy was performed and the stone was extracted with a basket after washing with balloon and basket, without incidents. The patient improved and liver function tests normalized.
Labor occurred at week 35 by cesarean section due to delayed uterine growth and presentation may occur with live fetus without complications.
One month later, a laparoscopic cholecystectomy was performed without incidents, and the patient and her child were asymptomatic after five years of follow-up.
