idiopathic fever after ERCP w/ stent placement

my wife underwent lap. chole (gall bladder removal) approx. 3 weeks ago.  subsequently she developed a bile leak-incurring the most horrific 36 hours of her life until they could detect the problem and place a stent in the bile duct via ERCP.  since then, aside from mild discomfort, lack of appetite, and occasional, low-grade fever, she has done well.  however over the past 3 days, she has developed considerable fevers, >103 F  which may temporarily respond to tylenol, breaking and causing profuse sweating, but, then, continually recur.  she has been somnolent, virtually unable to get out of bed for 3 days, has moderate headache, and aching in her legs.  we went to the ER on the first night (last friday) when the fever was 103+, blood cultures and standard labs checked.  CT of the abdomen was benign.  no peritoneal signs, no nuchal rigidity (stiff-neck), or photophobia to indicate meningitis.  nor is it the worst headache of her life, merely nagging and constant for 3 days.  her WBC were barely elevated at 10.8, no indicator of sepsis- though no lactic acid was drawn.  urine was negative.  no nausea, no vomiting, no cough, chest x-ray was also negative, no sign of blood clot, no leg swelling or redness.  pain in legs is diffuse and aching in character.  she was rehydrated in ER for mild dehydration, but remains dizzy when out of bed, fatigued and miserable.  she is a 40 year old, active, otherwise healthy woman.  this is not like her.  any thoughts?  is this to be expected as a complication/side effect of the bile leak?  could it be retrograde bacteria influx into the bile duct d/t the stent- though wouldn't that be reflected in the blood work?, is it d/t reabsorbtion of the bile in the abdominal cavity.  it seems late and unusually high temp. for an inflammatory response, is it not?  
i'm an ER nurse, this is not my area of expertise.  any thoughts before we venture back to the ER. (of course, it's a weekend, Dr.s offices are closed
thanks, Len


This discussion is related to Complications following Gall Bladder Surgery.

[AutiMom]

Hi! Your wife's situation sounds very similar to my own. I am also an otherwise healthy, active 40 year old woman. I had my lap chole on Feb 26th, with an immediate bile leak. The day surgery nurse pumped me full of pain meds and insisted I leave the hospital. I endured a huge bile leak for 7 days before I returned to the hospital. I was jaundiced, and just generally in bad shape. When they did surgery to try to fix the leak they got a liter of bile from my abdomen. They were unsuccessful at repairing the leak, so I had to be transported to a larger hospital for an ERCP with stent and bridge placement.    I too had a very high fever (104.8*) a few days after my ERCP procedure. I was hospitalized again and put on IV antibiotics for a suspected secondary infection.  It is several weeks after my last hospitalization now, and I am experiencing abdominal pain  (sometimes pretty severe) and fevers.  I am scheduled to have the bridge and stent removed next Thursday, but I am so miserable I attempted a Dr visit today to see if there is anything that will help me. I got to the Dr's office only to discover that the Dr's had gone early for the day to some sort of meeting...(welcome to small town America!)  Since it is the weekend the only option available to me now is the ER, and I don't want to pay the extra cost that would incur.  I am managing to get by using muscle relaxers and pain killers that were previously prescribed for a back injury.  I am very interested to know how your wife's situation turned out. I wish I could give you some advise...but I seem to be woefully lacking in knowledge about the situation as I am stuck in the same boat.  Hope all works out for you both.