Department of Gastroenterology and Hepatology, Kyorin University School of Medicine, Mitaka-shi, Tokyo, Japan.
Department of Gastroenterology and Hepatology, Kyorin University School of Medicine, Mitaka-shi, Tokyo, Japan
BMJ Case Rep. 2022 Mar 23;15(3):e248285. doi: 10.1136/bcr-2021-248285.
A woman in her 30s who was 12 weeks pregnant with her third child presented with jaundice. Blood tests showed elevated hepatobiliary enzymes and direct bilirubin. Abdominal ultrasonography showed dilatation of the common bile duct and strong echo with a 9 mm acoustic shadow in the distal bile duct. She was diagnosed with common bile duct stone disease and biliary drainage was considered necessary. Percutaneous transhepatic biliary drainage (PTBD) was performed considering the effect on both the fetus and the mother, and the procedure was successful without any complications. The PTBD tube was left in place until delivery at 36 weeks 6 days of gestation and endoscopic stone removal was performed 14 days after delivery. The patient was discharged 18 days after delivery without any complications. In pregnant women with common bile duct stones, palliative PTBD followed by elective endoscopic stone removal after delivery can be considered a treatment strategy.
一位 30 多岁的女性,怀孕 12 周,怀的是第三胎,出现黄疸。血液检查显示肝胆汁酶和直接胆红素升高。腹部超声显示胆总管扩张,远端胆管有 9 毫米强回声伴声影。她被诊断为胆总管结石病,需要胆道引流。考虑到对胎儿和母亲的影响,进行了经皮经肝胆道引流术(PTBD),手术过程顺利,没有任何并发症。PTBD 管一直保留到孕 36 周零 6 天分娩,并在分娩后 14 天进行了内镜取石术。患者在分娩后 18 天出院,没有任何并发症。对于患有胆总管结石的孕妇,分娩后行姑息性 PTBD 并择期行内镜取石术可作为一种治疗策略。