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.
Article
em En
| WPRIM
| ID: wpr-763427
Biblioteca responsável:
WPRO
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.
Palavras-chave
Texto completo:
1
Índice:
WPRIM
Assunto principal:
Pneumoperitônio
/
Bile
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Neoplasias da Bexiga Urinária
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Stents
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Drenagem
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Seguimentos
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Trato Gastrointestinal
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Perfuração Intestinal
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Intestino Delgado
Tipo de estudo:
Observational_studies
/
Prognostic_studies
Limite:
Aged
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Aged80
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Humans
Idioma:
En
Revista:
Clinical Endoscopy
Ano de publicação:
2019
Tipo de documento:
Article