Koda Megumu, Kaneko Junichi, Ida Yuya, Yamada Kenta, Fukita Kyoichi, Takeshita Yu, Takahashi Kenichi, Takinami Masaki, Tsuji Atsushi, Yamada Takanori
Division of Gastroenterology, Iwata City Hospital.
Nihon Shokakibyo Gakkai Zasshi. 2022;119(8):776-782. doi: 10.11405/nisshoshi.119.776.
A 92-year-old woman with gallstone pancreatitis and acute cholangitis was admitted to our hospital where endoscopic retrograde cholangiopancreatography was performed for emergency biliary drainage. Biliary cannulation was unsuccessful. Consequently, percutaneous transhepatic gallbladder drainage (PTGBD) was performed, and her symptoms improved. The PTGBD tube was removed by the patient on the third day of admission resulting in cardiopulmonary arrest two hours later. Cardiopulmonary resuscitation restored spontaneous circulation. Contrast computed tomography revealed intra-abdominal hemorrhage from the right hepatic artery by the removed part of the PTGBD tube. The patient died despite hemostasis by transcatheter artery embolization. PTGBD is generally effective and safe;however, it can cause fatal hemorrhage, especially if PTGBD tubes are removed by the patient. Thus, self-removal should be strictly prevented.
一名92岁患有胆石性胰腺炎和急性胆管炎的女性被收治入我院，在我院接受了内镜逆行胰胆管造影术以进行紧急胆道引流。胆管插管未成功。因此，进行了经皮经肝胆囊引流术（PTGBD），她的症状有所改善。患者在入院第三天自行拔除了PTGBD管，两小时后发生心脏骤停。心肺复苏恢复了自主循环。对比计算机断层扫描显示，拔除的PTGBD管导致右肝动脉腹腔内出血。尽管通过经导管动脉栓塞进行了止血，患者仍死亡。PTGBD通常有效且安全；然而，它可能导致致命性出血，尤其是当PTGBD管被患者自行拔除时。因此，应严格防止自行拔除。
