만성 췌장염 환자에서 췌관 스텐트 삽입 후 발생한 천공을 동반한 급성 담낭염 1예 |
김정욱, 동석호, 박철기, 채정민, 구자원, 김태영, 고원진, 홍성훈 |
경희대학교 의과대학 내과학교실
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A Case of Acute Cholecystitis with Perforation after Pancreatic Stent Insertion in a Patient with Chronic Pancreatitis |
Jung-Wook Kim, Seok Ho Dong, Choul Ki Park, Jungmin Chae, Ja Won Koo, Tae Young Kim, Weon-Jin Ko, Seonghoon Hong |
Department of Internal Medicine, College of Medicine, Kyung Hee University, Seoul, Korea |
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ABSTRACT |
Cholecystitis complicates approximately 0.2% to 0.5% of endoscopic retrograde cholangiopancreatographys (ERCPs). The risk appears to be correlated with the presence of stones in the gallbladder (GB), possibly filling of the GB with contrast, and placement of metal stents. However, acute acalculous cholecystitis with perforation after ERCP is extremely rare. A 56-year-old male with chronic pancreatitis was admitted for endoscopic treatment of chronic pancreatitis. Two days after pancreatic stent insertion, he presented with acute cholangitis without bile duct dilatation. He underwent two plastic biliary stents insertion. After two days, he had complained of acute right upper abdominal pain with muscle guarding. Abdominal computed tomographic scan showed focal discontinuity of GB wall and fluid collection of pericholecystic area and pelvic cavity. He had been successfully managed by percutaneous GB drainage and biliary stent removal without operation. Herein we report a case of acute acalculous cholecystitis with perforation that developed after ERCPs. |
Keywords:
endoscopic retrograde cholangiopancreatography, complication, acute cholecystitis, gallbladder perforation |
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