Epigastric pain in patients with biliary drainage. A symptom not to be overlooked

: Patients with longstanding percutaneous transhepatic biliary drainage often complain of epigastralgia. This symptom has occurred in 33% of the patients in our series. In all the patients complaining of these symptoms who underwent radiological or endoscopic examinations of Upper GI, there was evidence of gastric or duodenal ulcerative lesions which subsequently were cured by medical treatment. Administering anti-acids to those 13 patients who complained of epigastralgia, reduced the symptoms uniformly. The symptom has not been reported elsewhere in literature and is often not given enough importance by the medical practitioner who attributes the symptoms to the presence of the catheter and/or underlying disease. This symptom is more often a sign of a gastric of duodenal peptic lesion that needs to be actively investigated.