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胆囊切除术后医源性胆管门静脉瘘所致的胆道出血

Haemobilia due to iatrogenic portobiliary fistula after cholecystectomy.

作者信息

Hurtarte-Sandoval A R, Flores-Robles B J, Penate-Dardón J D, González-Galilea A

机构信息

Department of Nephrology, Reina Sofia Hospital, Córdoba, Spain.

出版信息

BMJ Case Rep. 2013 May 21;2013:bcr2013009768. doi: 10.1136/bcr-2013-009768.

Abstract

Haemobilia, defined as bleeding into the biliary tree is a rare condition. We describe a case report of a patient who presented it as a complication of iatrogenic portobiliary fistula, followed after an open cholecystectomy. The patient presented to the emergency department with late onset symptoms of haematemesis and melena a month after surgery. Findings were confirmed by Doppler ultrasound that showed the appearance of intragallbladder mass with high echogenicity representing a blood clot. Also, next to the portal vein and the biliary duct a lesion with mixed blood flow was detected confirming a portobiliary fistula. This case was successfully managed by angiography and selective embolisation.

摘要

胆道出血定义为血液流入胆道系统,是一种罕见的病症。我们报告一例患者,其在开腹胆囊切除术后出现医源性门静脉胆管瘘并发症,表现为胆道出血。该患者在术后一个月因出现呕血和黑便等迟发性症状就诊于急诊科。多普勒超声检查结果证实,胆囊内出现高回声团块,提示血凝块。此外,在门静脉和胆管旁检测到一个具有混合血流的病变,证实存在门静脉胆管瘘。该病例通过血管造影和选择性栓塞成功治愈。

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