RESUMO
Bile peritonitis is an infrequent complication of liver biopsy and is usually treated by supportive care or laparotomy. Fever, peritoneal signs, and hemoconcentration developed in a 56-year-old man 7 hr after biopsy. At laparoscopy, a large amount of cloudy, bilious fluid was aspirated using a suction-irrigation device. No liver injury or bile leak was seen. The patient gradually improved and, although he required percutaneous drainage of the subhepatic bile collection, did well. This case illustrates the new use of laparoscopy to manage bile peritonitis after liver biopsy. Compared with conventional laparotomy, this procedure has the advantages of lower intraoperative risk, shorter recovery time, and superior visualization of peritoneal contents.
Assuntos
Bile , Biópsia/efeitos adversos , Laparoscopia , Fígado/patologia , Peritonite/etiologia , Peritonite/cirurgia , Drenagem , Hepatite C/patologia , Hepatite Crônica/patologia , Humanos , Laparoscopia/métodos , Cirrose Hepática/patologia , Masculino , Pessoa de Meia-IdadeRESUMO
Two cases of aphthous ulceration apparently due to diversion colitis are described. There was no evidence of Crohn's disease initially or at follow-up. Aphthous ulceration of the colon and diversion colitis are reviewed, and the nonspecificity of aphthae for Crohn's disease is stressed. The presence of aphthous ulcers in a diverted colon should not preclude colostomy closure.