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1例由T管隐匿移位引起的罕见梗阻性黄疸病例。

A case of rare obstructive jaundice induced by concealed displacement of T-tube.

作者信息

Yangjun Gu, Qingqing Fang, Zhitao Chen, Qiyong Li

机构信息

Department of Hepatobiliary and Pancreatic Surgery, Shulan (Hangzhou) Hospital Affiliated to Zhejiang Shuren University Shulan International Medical College, #848 Dongxin Road, Hangzhou 310000, P. R. China.

Department of Plastic Surgery, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, 3 East Qingchun Road, #3 Qingchun Road, Hangzhou, 310016, P. R. China.

出版信息

J Surg Case Rep. 2024 Sep 18;2024(9):rjae587. doi: 10.1093/jscr/rjae587. eCollection 2024 Sep.

Abstract

We present the case of a 32-year-old woman who was ultimately diagnosed with obstructive jaundice. She exhibited persist jaundice, liver dysfunction with normal drainage of T-tube (400-500 ml per day), and normal stools. Prior to her admission to our department, she had undergone a cholecystectomy and T-tube placement following common bile duct exploration for cholelithiasis. Although her serum bilirubin levels initially decreased post-surgery, it rose sharply after T-tube cholangiography. The diagnosis remained unclear until we performed endoscopic retrograde cholangiopancreatography (ERCP), which revealed that the obstructive jaundice was induced by improper T-tube placement. There were few such presentations reported before, and it's particularly unusual to encounter jaundice following T-tube placement. Moreover, diagnosing and treating this condition can be challenging when T-tube drainage appears normal. Thus, our case report provides a unique contribution to the literature on obstructive jaundice.

摘要

我们报告一例最终被诊断为梗阻性黄疸的32岁女性病例。她表现为持续性黄疸、肝功能障碍,T管引流正常(每天400 - 500毫升),且大便正常。在她入住我们科室之前,因胆结石行胆总管探查术后接受了胆囊切除术和T管置入术。尽管术后她的血清胆红素水平最初有所下降,但在T管胆管造影术后急剧上升。在我们进行内镜逆行胰胆管造影(ERCP)之前,诊断一直不明确,ERCP显示梗阻性黄疸是由T管放置不当所致。此前鲜有此类病例报道,尤其罕见的是T管置入术后出现黄疸。此外,当T管引流看似正常时,诊断和治疗这种情况可能具有挑战性。因此,我们的病例报告为梗阻性黄疸的文献提供了独特的贡献。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3748/11410385/b84cbc154be9/rjae587f1.jpg

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