Katsinelos P, Dimiropoulos S, Katsiba D, Arvaniti M, Tsolkas P, Galanis I, Papaziogas B, Limenopoulos V, Baltajiannis S, Vasilladis I
Department of Endoscopy and Motility Unit, Central Hospital, Ethnikis Aminis 41, TT 54635 Thessaloniki, Greece.
Surg Endosc. 2002 Nov;16(11):1638. doi: 10.1007/s00464-002-4210-9. Epub 2002 Jun 27.
Patients with sphincter of Oddi dysfunction have a significantly increased rate of pancreatitis after manometry or sphincterotomy, but septic complications after diagnostic endoscopic retrograde cholangiopancreatography (ERCP) in patients with sphincter of Oddi dysfunction type 2 have not been reported. We describe two patients with sphincter of Oddi dysfunction type 2 in whom Pseudomonas aeruginosa serotype 10 septicemia and multiple small hepatic abscesses developed, all within 48 h after they underwent diagnostic ERCP. The sepsis and hepatic abscesses resolved after successful intravenous antibiotic administration. Despite scrupulous examination of the duodenoscope washing machine and the bottle of water, the bacteria responsible for the sepsis could not be isolated. It is possible that despite disinfection, a nondetectable colony of P. aeruginosa remained in a part of duodenoscope and proliferated to reach a potentially hazardous level the following day. This report highlights the importance administering antibiotic prophylaxis to patients with sphincter Oddi dysfunction type 2 who undergo ERCP, despite the functional nature of the disease.
Oddi括约肌功能障碍患者在测压或括约肌切开术后胰腺炎发生率显著增加，但2型Oddi括约肌功能障碍患者诊断性内镜逆行胰胆管造影（ERCP）后的感染并发症尚未见报道。我们描述了2例2型Oddi括约肌功能障碍患者，他们在接受诊断性ERCP后48小时内均发生了10型铜绿假单胞菌败血症和多个小肝脓肿。成功静脉应用抗生素后，败血症和肝脓肿得以缓解。尽管对十二指肠镜清洗机和水瓶进行了严格检查，但仍未分离出导致败血症的细菌。尽管进行了消毒，但十二指肠镜的某个部位可能仍残留有无法检测到的铜绿假单胞菌菌落，并在第二天增殖到潜在危险水平。本报告强调了对接受ERCP的2型Oddi括约肌功能障碍患者进行抗生素预防的重要性，尽管该疾病具有功能性。
