The benefit of emergency nasobiliary drain in cholelithiasis with ascending cholangitis, coagulopathy, and thrombocytopenia.

Severe coagulopathy in a male patient with septicemia, renal failure, and obstructive jaundice secondary to cholelithiasis precluded safe endoscopic sphincterotomy. A temporary nasobiliary drain, inserted at endoscopic retrograde cholangiopancreatography, decompressed the biliary tree, allowing eventual safe sphincterotomy and bile duct clearance after correction of coagulopathy and improvement in his clinical condition.