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CT 引导下经皮穿刺引流治疗内镜逆行胰胆管造影术后左肝包膜下血肿。

CT guided percutaneous drainage for left hepatic subcapsular hematoma after endoscopic retrograde cholangiopancreatography.

机构信息

Dalian Medical University.

Affiliated Hospital of Weifang Medical University.

出版信息

Rev Esp Enferm Dig. 2023 Nov;115(11):655-656. doi: 10.17235/reed.2023.9498/2023.

Abstract

Endoscopic retrograde cholangiopancreatography has been widely used in the diagnosis and treatment of biliary and pancreatic diseases. Post-ERCP complications mainly include pancreatitis, infection, bleeding, and perforation. However, post-ERCP left hepatic subcapsular hematoma is a rare and potentially life-threatening complication. A total of five cases have been reported in the literature, including one death due to bleeding from a ruptured hematoma. We report a case of post-ERCP hepatic subcapsular hematoma of the left lobe of the liver in a 29-year-old woman who was diagnosed with a left hepatic subcapsular hematoma 56 hours after ERCP and whose symptoms did not improve after conservative treatment. A CT-guided percutaneous puncture was then performed, and the drainage fluid was a dark red fluid mixed with blood and bile. On days 1, 2, 3, 4, and 5, respectively, following drainage, the drainage flow was 400 ml, 40 ml, 70 ml, 50 ml, and 30 ml.

摘要

经内镜逆行胰胆管造影术已广泛应用于胆道和胰腺疾病的诊断和治疗。ERCP 术后并发症主要包括胰腺炎、感染、出血和穿孔。然而,ERCP 术后左肝包膜下血肿是一种罕见且潜在危及生命的并发症。文献中总共报告了 5 例病例,其中 1 例因血肿破裂出血而死亡。我们报告了 1 例 29 岁女性 ERCP 后左肝包膜下血肿的病例,该患者在 ERCP 后 56 小时被诊断为左肝包膜下血肿,保守治疗后症状未改善。随后进行了 CT 引导下经皮穿刺,引流液为暗红色液体,混合血液和胆汁。引流后第 1、2、3、4 和 5 天,引流流量分别为 400ml、40ml、70ml、50ml 和 30ml。

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