학술논문

A fatal case intra-abdominal hemorrhage following self-removal of a percutaneous transhepatic gallbladder drainage tube / PTGBDチューブの自己抜去後に致命的な腹腔内出血をきたした1例
Document Type
Journal Article
Source
日本消化器病学会雑誌 / Nippon Shokakibyo Gakkai Zasshi. 2022, 119(8):776
Subject
偶発症
経カテーテル的動脈塞栓術
経皮経肝胆囊ドレナージ(PTGBD)
腹腔内出血
自己抜去
Language
Japanese
ISSN
0446-6586
1349-7693
Abstract
A 92-year-old woman with gallstone pancreatitis and acute cholangitis was admitted to our hospital where endoscopic retrograde cholangiopancreatography was performed for emergency biliary drainage. Biliary cannulation was unsuccessful. Consequently, percutaneous transhepatic gallbladder drainage (PTGBD) was performed, and her symptoms improved. The PTGBD tube was removed by the patient on the third day of admission resulting in cardiopulmonary arrest two hours later. Cardiopulmonary resuscitation restored spontaneous circulation. Contrast computed tomography revealed intra-abdominal hemorrhage from the right hepatic artery by the removed part of the PTGBD tube. The patient died despite hemostasis by transcatheter artery embolization. PTGBD is generally effective and safe;however, it can cause fatal hemorrhage, especially if PTGBD tubes are removed by the patient. Thus, self-removal should be strictly prevented.