Wang Xiao Jing, Buttar Navtej, Storm Andrew C
Department of Gastroenterology and Hepatology, Mayo Clinic, Rochester, MN.
ACG Case Rep J. 2019 Oct 17;6(10):e00254. doi: 10.14309/crj.0000000000000254. eCollection 2019 Oct.
Spontaneous hemobilia is a rare complication after liver transplantation and is largely secondary to the formation of an arteriobiliary fistula, which is generally treated by vascular interventional radiology embolization. We present a case of hemorrhagic shock secondary to arterial hemorrhage at an oversewn bile duct stump after liver transplantation, which failed vascular interventional radiology embolization, and was subsequently controlled using an endoscopic application of a gelatin sponge slurry (Gelfoam). We present this unique approach and review the history of this surgical and interventional hemostasis tool that has not been previously described for endoscopic use.
自发性肝内胆管出血是肝移植术后一种罕见的并发症，主要继发于肝动脉-胆管瘘的形成，通常采用血管介入放射栓塞治疗。我们报告一例肝移植术后胆管残端动脉出血继发失血性休克的病例，血管介入放射栓塞治疗失败，随后通过内镜应用明胶海绵糊剂（明胶海绵）得以控制。我们介绍这种独特的方法，并回顾这种手术和介入止血工具的历史，此前尚未有内镜使用的相关描述。
