Pran Lemuel, Moonsie Reena, Byam James, BahadurSingh Shivraj, Manjunath Gurubasavaiah, Seenath Marlon, Baijoo Shanta
Department of Surgery, Eric Williams Medical Sciences Complex, Champs Fleurs, Trinidad and Tobago; Department of Clinical Surgical Sciences, University of the West Indies, Eric Williams Medical Sciences Complex, Champs Fleurs, Trinidad and Tobago.
Department of Surgery, Eric Williams Medical Sciences Complex, Champs Fleurs, Trinidad and Tobago.
Int J Surg Case Rep. 2017;34:81-83. doi: 10.1016/j.ijscr.2017.03.010. Epub 2017 Mar 18.
Haemobilia is an uncommon entity even though its frequency has increased with hepato-biliary instrumentation and procedures. It can be associated with obstructive jaundice and pancreatitis (Green et al., 2001) [1]. Haemobilia following cholecystectomy has frequently been reported in association with hepatic artery pseudo-aneurysm (Curet et al., 1981; Ribeiro et al., 1998) [2,3]. The authors wish to report a case of haemobilia due to a porto-biliary fistula presenting as acute pancreatitis.
A 34-year-old female admitted as an urgency with upper abdominal pain for 3 weeks. She had, in the preceding days, been admitted to another hospital with acute pancreatitis. She reported an episode of rectal bleeding during that admission and possessed an abdominal ultrasound scan (USS) and magnetic resonance cholangiopancreatography (MRCP) which suggested the presence of a biliary tract neoplasm. The patient was also found to be jaundiced and the diagnosis of a porto-biliary fistula was made at operation.
The diagnosis in this case was found to be a portal vein-biliary tract fistula occurring post cholecystectomy. An awareness of the spectrum of complications related to modern surgical techniques may aid timely diagnosis and the achievement of favourable outcomes.
尽管随着肝胆器械检查和手术的开展，胆道出血的发生率有所上升，但它仍是一种罕见的病症。它可能与梗阻性黄疸和胰腺炎相关（格林等人，2001年）[1]。胆囊切除术后的胆道出血常被报道与肝动脉假性动脉瘤有关（库雷等人，1981年；里贝罗等人，1998年）[2,3]。作者希望报告一例因门静脉 - 胆管瘘导致的胆道出血，表现为急性胰腺炎的病例。
一名34岁女性因上腹部疼痛3周紧急入院。在前几天，她因急性胰腺炎被收治于另一家医院。她报告在那次住院期间有一次直肠出血，并进行了腹部超声扫描（USS）和磁共振胰胆管造影（MRCP），结果提示存在胆道肿瘤。患者还出现黄疸，手术时诊断为门静脉 - 胆管瘘。
该病例的诊断为胆囊切除术后发生的门静脉 - 胆管瘘。了解与现代手术技术相关的并发症范围可能有助于及时诊断并取得良好的治疗效果。
