Department of Gastroenterology, Virginia Mason Medical Center, Seattle, WA 98101, USA.
World J Gastroenterol. 2010 Jun 28;16(24):3083-6. doi: 10.3748/wjg.v16.i24.3083.
Biliary obstructions can lead to infections of the biliary system, particularly in patients with occluded biliary stents. Fungal organisms are frequently found in biliary aspirates of patients who have been on antibiotics and have stents; however, fungal masses, or "balls", that fully obstruct the biliary system are uncommon and exceedingly difficult to eradicate. We present 4 cases of obstructing fungal cholangitis in patients who had metal biliary stents placed for pancreatic malignancies, and subsequently required aggressive antifungal administration along with endoscopic and radiologic interventions. This report also reviews approaches previously undertaken to manage severe obstructing fungal cholangitis.
胆道阻塞可导致胆道系统感染,尤其是在阻塞性胆道支架置入的患者中。接受抗生素治疗并置入支架的患者的胆汁抽吸物中常可发现真菌,但完全阻塞胆道的真菌团块(“球”)则较为少见且极难清除。我们报告了 4 例因胰腺恶性肿瘤而置入金属胆道支架的患者发生阻塞性真菌性胆管炎的病例,随后需要进行积极的抗真菌治疗以及内镜和放射介入干预。本报告还回顾了既往用于治疗严重阻塞性真菌性胆管炎的方法。