KMID : 1038120190520030288
|
|
Clinical Endoscopy 2019 Volume.52 No. 3 p.288 ~ p.292
|
|
Pneumoperitoneum after Endoscopic Duodenal Stent Insertion in a Patient with Percutaneous Transhepatic Biliary Drainage and Biliary Stent: A Case Report
|
|
Choi Jin-Woo
Lee Min-Ji Lee Hyo-Deok Kim Yook Han Joung-Ho Park Seon-Mee
|
|
Abstract
|
|
|
Early removal of a percutaneous transhepatic biliary drainage (PTBD) tube commonly causes pneumoperitoneum. However, we encountered a patient who developed pneumoperitoneum even with an indwelling PTBD tube. An 84-year-old man was admitted with type III combined duodenal and biliary obstruction secondary to metastatic bladder cancer. A biliary stent was placed using a percutaneous approach, and a duodenal stent was placed endoscopically. A large amount of subphrenic free air was detected after the procedures. Laboratory tests indicated intestinal perforation; however, peritoneal signs were absent. The patient was treated conservatively using an indwelling Levin tube. Seven days later, the massive amount of subphrenic free air disappeared. Follow-up tubography revealed unrestricted bile flow into the small intestine, and the PTBD tube was removed. Prolonged endoscopic procedures in patients with a PTBD tract communicating with the gastrointestinal tract can precipitate pneumoperitoneum. Clinicians should be careful to avoid misdiagnosing this condition as intestinal perforation.
|
|
KEYWORD
|
|
Pneumoperitoneum, Combined duodenal and biliary obstruction, Percutaneous transhepatic biliary drainage, Biliary stenting, Duodenal stenting
|
|
FullTexts / Linksout information
|
|
|
|
Listed journal information
|
|
|