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一名原发性骨髓纤维化患者在顺利完成内镜逆行胰胆管造影术后发生急性十二指肠缺血和壶腹周围壁内血肿。

Acute duodenal ischemia and periampullary intramural hematoma after an uneventful endoscopic retrograde cholangiopancreatography in a patient with primary myelofibrosis.

作者信息

Jung Chang Ho, Hyun Jong Jin, Gu Dae Hoe, Moon Eul Sun, Kim Jae Seon, Lee Hong Sik, Kim Chang Duck

机构信息

Division of Gastroenterology and Hepatology, Department of Internal Medicine, Korea University College of Medicine, Seoul, Korea.

出版信息

Clin Endosc. 2014 May;47(3):270-4. doi: 10.5946/ce.2014.47.3.270. Epub 2014 May 31.

DOI:10.5946/ce.2014.47.3.270
PMID:24944994
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC4058548/
Abstract

Acute duodenal ischemia and periampullary intramural hematoma are rare complications after endoscopic retrograde cholangiopancreatography (ERCP). A 77-year-old man with splenomegaly complained of abdominal pain caused by common bile duct (CBD) stone. After successful removal of the CBD stone without immediate complications, the patient developed intramural hematoma around the ampulla of Vater along with diffuse duodenal edema. The findings were compatible with acute intestinal ischemia, and further evaluation revealed that he had underlying primary myelofibrosis. Myeloproliferative diseases are known to be significantly associated with an increased risk of thrombohemorrhagic complications. Therefore, particular attention should be given to this group of patients when a high-risk procedure such as ERCP is performed.

摘要

急性十二指肠缺血和壶腹周围壁内血肿是内镜逆行胰胆管造影术（ERCP）后罕见的并发症。一名77岁脾肿大男性因胆总管结石主诉腹痛。成功取出胆总管结石且未立即出现并发症后，患者发生了Vater壶腹周围壁内血肿以及弥漫性十二指肠水肿。这些表现符合急性肠缺血，进一步评估发现他患有潜在的原发性骨髓纤维化。已知骨髓增殖性疾病与血栓出血性并发症风险增加显著相关。因此，对这类患者进行ERCP等高风险操作时应格外关注。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f02c/4058548/83ff6ec60c37/ce-47-270-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f02c/4058548/1fba9cbe9b57/ce-47-270-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f02c/4058548/a8c138072fea/ce-47-270-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f02c/4058548/83ff6ec60c37/ce-47-270-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f02c/4058548/1fba9cbe9b57/ce-47-270-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f02c/4058548/a8c138072fea/ce-47-270-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f02c/4058548/83ff6ec60c37/ce-47-270-g003.jpg

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