Ch Ávez-S Ánchez Siomara Aransuzú, Bellido-Caparó Álvaro, Alvarado-Jaramillo Ramón, Ramírez-Cotrina César Augusto, Tagle-Arróspide Martín
Gastroenterology Service, Cayetano Heredia National Hospital. Lima, Peru.
Gastroenterology Service, Cayetano Heredia National Hospital. Lima, Peru; Professor at the "Alberto Hurtado" School of Medicine - Cayetano Heredia Peruvian University, Peru.
Rev Gastroenterol Peru. 2023 Jan-Mar;43(1):60-64.
Pneumobilia is a phenomenon associated with the presence of a biliary-enteric fistula or manipulation of the bile duct during procedures or surgical interventions that cause dysfunction of the sphincter of Oddi. A known, but infrequently reported event, is the increase in intraabdominal pressure after closed abdominal trauma, which causes pneumobilia due to a mechanism of retrograde air leakage towards the bile duct. Depending on the general compromise of each patient, the prognosis can vary from a benign condition that only requires conservative management, to being life threatening. We present the case of a 75-year-old male patient who, after suffering a closed thoraco-abdominal trauma, presented with rib fracture and, in addition, gallbladder wall rupture, pneumoperitoneum, pneumobilia, and pneumowirsung, having a favorable clinical course after receiving conservative management.
胆内积气是一种与胆肠瘘存在相关的现象，或者是在导致Oddi括约肌功能障碍的操作或外科手术干预过程中对胆管进行操作所引发的。一种已知但较少报道的情况是，闭合性腹部创伤后腹腔内压力升高，通过向胆管逆行漏气的机制导致胆内积气。根据每位患者的总体病情，预后可能从仅需保守治疗的良性情况到危及生命不等。我们报告一例75岁男性患者，在遭受闭合性胸腹创伤后，出现肋骨骨折，此外还伴有胆囊壁破裂、气腹、胆内积气和胰管积气，在接受保守治疗后临床病程良好。
