Di Virgilio D, Colella F, Lancia A, Nicolella U, Ravallese F, Lucherini M, Cavacece A
Divisione di Medicina Interna, Ospedale Generale Figlie di S. Camillo, Roma.
Ann Ital Med Int. 1992 Jul-Sep;7(3):179-81.
The authors report an unusual case of intracholecystic hemorrhage related to liver biopsy in a 23-year-old man. Echography and computed tomography evidenced changes in density within the gallbladder which were probably caused by hemorrhagic discharge. Although the mechanism by which liver biopsy induced intracholecystic hemorrhage is unclear, the authors believe that this iatrogenic complication was probably the result of microlesions of the gallbladder wall caused by needle puncture: the lesions extended into the submucosa and provoked slow hematic leakage. The pain syndrome began 48 hours after biopsy. The peculiarity of this case report was confirmed by the fact that no bile was aspirated, no choleperitoneum was found, and no gallbladder tissue was detected in the sample. The authors conclude by recommending clinical and echographic control following liver biopsy.
作者报告了一例23岁男性因肝活检引发胆囊内出血的罕见病例。超声检查和计算机断层扫描显示胆囊内密度改变,这可能是由出血性渗出所致。虽然肝活检引发胆囊内出血的机制尚不清楚,但作者认为这种医源性并发症可能是针刺导致胆囊壁微损伤的结果:损伤延伸至黏膜下层并引起缓慢的血液渗漏。疼痛综合征在活检后48小时开始。该病例报告的特殊性在于未抽出胆汁,未发现胆汁性腹膜炎,且样本中未检测到胆囊组织。作者通过建议肝活检后进行临床和超声检查来得出结论。