Pneumoperitoneum after Endoscopic Duodenal Stent Insertion in a Patient with Percutaneous Transhepatic Biliary Drainage and Biliary Stent: A Case Report
Clinical Endoscopy
;
: 288-292, 2019.
Artículo
en Inglés
| WPRIM
| ID: wpr-763427
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.
Texto completo:
Disponible
Índice:
WPRIM (Pacífico Occidental)
Asunto principal:
Neumoperitoneo
/
Bilis
/
Neoplasias de la Vejiga Urinaria
/
Stents
/
Drenaje
/
Estudios de Seguimiento
/
Tracto Gastrointestinal
/
Perforación Intestinal
/
Intestino Delgado
Tipo de estudio:
Estudio observacional
/
Estudio pronóstico
Límite:
Anciano
/
Aged80
/
Humanos
Idioma:
Inglés
Revista:
Clinical Endoscopy
Año:
2019
Tipo del documento:
Artículo
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