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术后复发性黄疸和发热:一例由胆道出血引起的误诊病例。

Postoperative recurrent jaundice and fever: A deceptive case caused by hemobilia.

作者信息

Yang Hanrui, Hu Kuan, Zhou Ledu

机构信息

Department of Liver Surgery, Xiangya Hospital, Central South University, Changsha 410008, Hunan, China.

Department of Liver Surgery, Xiangya Hospital, Central South University, Changsha 410008, Hunan, China.

出版信息

Int J Surg Case Rep. 2024 Jul;120:109821. doi: 10.1016/j.ijscr.2024.109821. Epub 2024 May 29.

Abstract

INTRODUCTION

Intrahepatic cholelithiasis is a common disease for which laparoscopic liver resection is one of the treatment options. Here is a case of a patient who developed atypical complications after liver resection.

CASE PRESENTATION

A 59-year-old patient with intrahepatic cholelithiasis underwent laparoscopic left hemihepatectomy in our hospital. However, the patient developed recurrent fever and jaundice after surgery. And with multiple treatments, the symptoms improved and the diagnosis was finally confirmed.

DISCUSSION

This case has some educational value as it shows that post-operative hepatic stones can lead to biliary hemorrhage due to infection and that imaging and signs can be deceptive to some extent.

CONCLUSION

In patients with intrahepatic cholelithiasis who present with symptoms of fever and jaundice after hepatectomy, hemobilia cannot be completely ruled out, even if the fecal occult blood test is negative.

摘要

引言

肝内胆管结石是一种常见疾病,腹腔镜肝切除术是其治疗选择之一。以下是一例肝切除术后出现非典型并发症的患者病例。

病例介绍

一名59岁的肝内胆管结石患者在我院接受了腹腔镜左半肝切除术。然而,患者术后出现反复发热和黄疸。经过多种治疗,症状有所改善,最终确诊。

讨论

该病例具有一定的教育意义,因为它表明术后肝内结石可因感染导致胆道出血,且影像学检查和体征在一定程度上可能具有欺骗性。

结论

对于肝内胆管结石患者,肝切除术后出现发热和黄疸症状时,即使粪便潜血试验为阴性,也不能完全排除胆道出血的可能。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f322/11225179/8c717ab9777c/gr1.jpg

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