Kolli Sindhura, Shahnazarian Vahe, Gurram Harini, Reddy Madhavi, Gurram Krishna
Internal Medicine, New York University (NYU) Langone Hospital, New York, USA.
Gastroenterology and Hepatology, The Brooklyn Hospital Center, Affiliate of the Icahn School of Medicine Mount Sinai, Brooklyn, USA.
Cureus. 2020 Oct 20;12(10):e11059. doi: 10.7759/cureus.11059.
Bilomas are unexpected post-procedural complications of cholecystectomies, hepatic resections, endoscopic retrograde cholangiopancreatography, and-rarely-liver biopsies. While uncommon, this should remain high on the differential in a patient presenting with sudden postop sepsis even in the absence of significant liver injury. Diagnosis involves coordination between interventional radiology, gastroenterology, and internal medicine. This involves a precise clinical history, invasive radiological techniques, and advanced interventional endoscopic solutions for diagnosis and treatment. This is a case of a biloma that occurred as a consequence of a post-hepatic biopsy and resulted in fungal infection, rather than its more common bacterial counterpart. Due to the unusual circumstances, a more circuitous route to the correct diagnosis and treatment was undertaken.
胆汁瘤是胆囊切除术、肝切除术、内镜逆行胰胆管造影术以及极少情况下肝活检术后意外出现的并发症。虽然不常见,但对于术后突然发生败血症的患者,即使没有明显肝损伤,在鉴别诊断时也应将其列为重点考虑对象。诊断需要介入放射科、胃肠病科和内科之间的协作。这包括详细准确的临床病史、侵入性放射学技术以及先进的介入内镜诊断和治疗方案。这是一例因肝活检后发生胆汁瘤并导致真菌感染的病例,而非更常见的细菌感染。由于情况特殊,采取了一条更为曲折的途径来进行正确的诊断和治疗。