不同类型的内镜逆行胰胆管造影术（ERCP）相关施塔费尔IV级损伤的治疗：一例病例报告及文献综述
Treatments for different types of ERCP-related Stapfer IV injury: a case report and literature review.
作者信息
Liang Hao, Yang Min, Liu Yuan-Jun
机构信息
Department of Hepatobiliary Surgery, Suining Central Hospital, Suining, Sichuan, China.
出版信息
Front Med (Lausanne). 2025 Apr 30;12:1549795. doi: 10.3389/fmed.2025.1549795. eCollection 2025.
BACKGROUND
As the endoscopic retrograde cholangiopancreatography (ERCP) is commonly used, some rare ERCP-related perforation cases have garnered attention. This study aims to report a rare case of Stapfer IV injury accompanied by severe infections and review the appropriate treatment methods for patients with different types of Stapfer IV injury.
CASE SUMMARY
A female patient received ERCP treatments, but she soon presented with massive diffuse abdominal and thoracic gas accompanied by severe infections. In the following upper gastrointestinal radiography examination, no signs of gastrointestinal perforations were observed. After receiving antibiotic treatments and percutaneous transhepatic gallbladder drainage therapy, the patient recovered and was discharged. Finally, she was diagnosed with Stapfer IV injury and cholecystitis.
CONCLUSION
Simple Stapfer IV injury was not a true perforation, and the conservative treatment was feasible. When a severe infection occurs in a patient with Stapfer IV injury, the other complications of ERCP procedures, such as cholecystitis, should be taken into consideration. Interventions for the source of infections, not just for the Stapfer IV injury, might be effective.
背景
随着内镜逆行胰胆管造影术（ERCP）的广泛应用，一些罕见的ERCP相关穿孔病例受到关注。本研究旨在报告一例罕见的伴有严重感染的斯塔弗IV型损伤病例，并回顾不同类型斯塔弗IV型损伤患者的适当治疗方法。
病例摘要
一名女性患者接受了ERCP治疗，但很快出现大量弥漫性腹部和胸部积气并伴有严重感染。在随后的上消化道造影检查中，未观察到胃肠道穿孔迹象。接受抗生素治疗和经皮经肝胆管引流治疗后，患者康复出院。最终，她被诊断为斯塔弗IV型损伤和胆囊炎。
结论
单纯的斯塔弗IV型损伤并非真正的穿孔，保守治疗是可行的。当斯塔弗IV型损伤患者发生严重感染时，应考虑ERCP手术的其他并发症，如胆囊炎。针对感染源而非仅针对斯塔弗IV型损伤进行干预可能有效。
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