Acute pancreatitis caused by ceftriaxone-associated biliary pseudolithiasis in an older patient: A case report and literature review

A 73-year-old woman was hospitalized with fever and back pain. Ceftriaxone (2 g/day) was administered due to suspicion of bacterial infection. On hospital day 5, ceftriaxone was replaced with cefepime. Three days later, the patient experienced abdominal pain and vomiting, which was associated with elevated serum amylase levels. Computed tomography revealed high-density sludge in the gallbladder and common bile duct, along with diffuse enlargement of the pancreas. The patient was diagnosed with acute pancreatitis caused by ceftriaxone-associated biliary pseudolithiasis and treated conservatively. Physicians should recognize that acute pancreatitis due to biliary pseudolithiasis may occur not only during ceftriaxone therapy but also after its discontinuation.