Tiruneh Fasil, Awan Ahmad, Musa Abdullahi, Chen Daniel
Department of Internal Medicine, Howard University Hospital.
Internal Medicine, Washington Dc Va Medical Center.
Cureus. 2017 Jul 3;9(7):e1421. doi: 10.7759/cureus.1421.
We describe a 69-year-old male patient with the status of obstructive jaundice post percutaneous biliary drainage for prior obstructive jaundice and who presented with a complaint of generalized weakness and increased output from the drainage tube. The patient developed worsening jaundice, which was noted to be obstructive in nature with a marked dilatation of the biliary tree and a distal obstruction of the common bile duct. Subsequently, a percutaneous biliary drain was placed for symptomatic management. However, the patient continued to have increased output from the drain, approximating 3-4 liters a day, which made the patient dependent on continuous intravenous hydration. The case presented a therapeutic challenge in reducing the drainage amount. We have tried a successful approach based on the physiologic effect of octreotide and nonsteroidal anti-inflammatory drugs (NSAIDs) in the formation of bile secretion. This approach has not been clearly described in the literature. We highlight the importance of further study to validate the use of these medications in similar clinical scenarios.
我们描述了一名69岁男性患者，既往因梗阻性黄疸行经皮胆道引流术，此次因全身乏力及引流管引流量增加前来就诊。患者黄疸加重，经检查为梗阻性黄疸，伴有胆管树明显扩张及胆总管远端梗阻。随后，为进行症状管理置入了经皮胆道引流管。然而，患者引流管引流量持续增加，每天约3 - 4升，这使得患者依赖持续静脉补液。该病例在减少引流量方面面临治疗挑战。我们基于奥曲肽和非甾体抗炎药（NSAIDs）对胆汁分泌形成的生理作用尝试了一种成功的方法。文献中尚未明确描述过这种方法。我们强调进一步研究以验证这些药物在类似临床情况中的应用的重要性。
