금속스텐트 삽입술로 호전된 총담관의 자연 천공 (Spontaneous Common Bile Duct Perforation Treated with Placement of Metal Stent)

서지정보

· 발행기관 : 대한췌장담도학회
· 수록지 정보 : 대한췌담도학회지 / 21권 / 4호 / 222 ~ 227페이지
· 저자명 : 양동훈, 박상욱, 문형철, 유경완, 은서준, 문승기, 박철민, 조신형

초록

총담관의 자발적 천공은 흔하지 않으며, 이에 대해 충분한연구와 경험이 부족한 상태이다. 본 저자들은 원인을 알 수없는 복통과 난치성 복수를 호소하는 환자에서 총담관의 자발적 천공을 진단하고, 내시경역행담췌관조영술을 통한 완전피막형 자가팽창형 금속스텐트의 삽입술과 보존적 치료를통하여 치료에 성공했던 증례를 경험하였기에 보고한다.

영어초록

Perforation of the biliary tree mostly results from injury to the bile duct during surgery or procedures such as endoscopic retrograde cholangiopancreatography (ERCP) and spontaneous bile duct perforation is rare in adults. As the clinical picture varies, early diagnosis and treatment of spontaneous biliary peritonitis is difficult. A 52-year-old male patient presented with abdominal pain and intractable ascites. He already experienced severe abdominal pain 2 months ago and underwent percutaneous pigtail drainage for the ascites at nearby hospital. ERCP showed large filling defect with leakage of contrast media from the mid common bile duct (CBD) into the peritoneal cavity. We performed endoscopic sphincterotomy and extracted CBD stones with basket and balloon catheter. Then fully covered self expandable metal stent was placed in CBD. After the procedure, the symptom was improved and the amount of pigtail drainage from abdominal cavity was dramatically decreased. 6 weeks later, removing the metal stent, there was no more leakage of contrast media into peritoneal cavity. We report a very rare case of spontaneous bile leakage which was successfully managed with placement of metal stent.

참고자료

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