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Cholesterol Revisited

Arch Surg. 1999;134:1398-1399.

	Since this article does not have an abstract, we have provided the first 150 words of the full text and any section headings.

THE CALL from a junior medical resident at Lakeside Hospital in Cleveland, Ohio, was puzzling.

"We have a 55-year-old lady with a serum cholesterol of 600 mg percent because there is a stone blocking her common bile duct!"

"Is she jaundiced?"

"Not at all. The stone is causing cholesterol to back up."

I had learned by the time I was chief resident, in 1964, not to play 20 questions with referring doctors. Stifling incredulity, I replied, "I'll be right there."

Findings from the cholangiogram showed an enlarged common bile duct with a large stone; there was no bilirubinemia, and alkaline phosphatase levels were moderately elevated. Her gallbladder had been removed leaving a long cystic duct stump. After choledochotomy and T-tube drainage, the laboratory head graciously honored my unusual request for daily serum cholesterol levels.

Over the next 10 days, the serum cholesterol fell to a level of 140 mg/dL and . . . [Full Text of this Article]

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