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内镜医源性胆道出血的非手术治疗:病例报告及文献复习

Non-operative management of endoscopic iatrogenic haemobilia: case report and review of literature.

作者信息

Siu W T, Chau C H, Ka Bo Law B, Yau K K, Luk Y W, KaWah Li M

机构信息

Department of Surgery, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, NT.

出版信息

Acta Gastroenterol Belg. 2005 Oct-Dec;68(4):428-31.

Abstract

Haemobilia denotes an abnormal communication between a vessel of the splanchnic circulation and the biliary system. Patients typically presents with the triad of abdominal pain, upper gastrointestinal haemorrhage, and jaundice. Common causes for haemobilia are iatrogenic causes secondary to hepatobiliary system instrumentation and trauma. Management of patients with haemodynamic significant haemobilia is aimed at stopping bleeding, maintaining continuous flow of biliary system, and cure of the underlying aetiology. Iatrogenic haemobilia after ERCP polyethylene biliary endoprosthesis placement is extremely uncommon. Herein we present a case of iatrogenic haemobilia triggered by biliary endoprosthesis placement and was successfully managed by non-operative treatment. The management algorithm for a rational approach to haemobilia is discussed.

摘要

胆道出血是指内脏循环血管与胆道系统之间存在异常交通。患者通常表现为腹痛、上消化道出血和黄疸三联征。胆道出血的常见原因是肝胆系统器械操作和创伤继发的医源性原因。对血流动力学有显著影响的胆道出血患者的治疗旨在止血、维持胆道系统持续通畅以及治愈潜在病因。内镜逆行胰胆管造影(ERCP)放置聚乙烯胆道内支架后发生医源性胆道出血极为罕见。在此,我们报告一例由胆道内支架放置引发的医源性胆道出血病例,并通过非手术治疗成功治愈。文中还讨论了针对胆道出血的合理处理的管理算法。

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