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创伤性胆瘘伴胆管离断。

Traumatic biliary fistula with bile duct disconnection.

机构信息

Gastroenterology, Clinical Medical College. Yangzhou University, China.

出版信息

Rev Esp Enferm Dig. 2024 Aug;116(8):438-439. doi: 10.17235/reed.2024.10096/2023.

Abstract

A 43-year-old man was admitted to our department for accident. Computed tomography (CT) scan revealed low-density shadows in the hepatogastric and peripancreatic space. The patient still has abdominal pain after the performation of CT-guided abdominal puncture and drainage. Magnetic Resonance Cholangiopancreatography (MRCP) showed that the middle and lower segments of common bile duct were stricture and truncature. Endoscopic bile duct catheterization and drainage showed that the lower segment was dislocated and disconnected. Then the doctor used the balloon and contrast agent to pressurize, and at the same time, the distal common bile duct was pulled by the mirror, trying to straighten the common bile duct, changing its axial direction, and try to bridge it repeatedly by using the guide wire of misgurnus anguillicaudatus. The patient significantly improved over the next 3 days. After 11 months of follow-up, the patient came to our hospital to remove the biliary stent,and has no abdominal pain anymore.

摘要

一位 43 岁男性因意外到我院就诊。计算机断层扫描(CT)显示肝胃和胰周间隙有低密度阴影。行 CT 引导下腹腔穿刺引流后,患者仍有腹痛。磁共振胰胆管成像(MRCP)显示胆总管中段和下段狭窄截断。内镜下胆管置管引流显示下段脱位断开。然后医生使用球囊和造影剂加压,同时用镜子牵拉远端胆总管,试图拉直胆总管,改变其轴向方向,并多次尝试用泥鳅导丝搭桥。患者在接下来的 3 天内明显好转。随访 11 个月后,患者来我院取出胆管支架,无腹痛。

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