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Pneumoperitoneum caused by transhepatic air leak after metallic biliary stent placement

Authors
 Jei Hee Lee  ;  Deok Hee Lee  ;  Jeong-Sik Yu  ;  Se Joon Lee  ;  Woo-Cheol Kwon  ;  Ki Whang Kim 
Citation
 Cardiovascular and Interventional Radiology, Vol.23(6) : 482-484, 2000 
Journal Title
 Cardiovascular and Interventional Radiology 
ISSN
 0174-1551 
Issue Date
2000
MeSH
Adenocarcinoma/complications ; Adenocarcinoma/diagnostic imaging ; Adenocarcinoma/pathology ; Aged ; Biopsy, Needle ; Cholangiopancreatography, Endoscopic Retrograde ; Cholestasis, Extrahepatic/diagnostic imaging ; Cholestasis, Extrahepatic/etiology ; Cholestasis, Extrahepatic/surgery* ; Common Bile Duct Diseases/diagnostic imaging ; Common Bile Duct Diseases/etiology ; Common Bile Duct Diseases/surgery* ; Humans ; Male ; Palliative Care ; Pancreatic Neoplasms/complications ; Pancreatic Neoplasms/diagnostic imaging ; Pancreatic Neoplasms/pathology ; Pneumopericardium/diagnostic imaging ; Pneumopericardium/etiology* ; Pneumopericardium/therapy ; Prosthesis Failure* ; Prosthesis Implantation/instrumentation* ; Sphincter of Oddi/diagnostic imaging ; Sphincter of Oddi/injuries* ; Stents* ; Suction ; Tomography, X-Ray Computed
Keywords
Bile ducts ; interventional procedure—Stents and prostheses—Pneumoperitoneum
Abstract
A self-expanding metallic biliary stent was placed for palliation of a common bile duct obstruction in a 68-year-old male with unresectable pancreatic head cancer 3 days after initial percutaneous right transhepatic catheter decompression. The stent crossed the ampulla of Vater. Three days later, the stent was balloon-dilated and the percutaneous access was removed. At removal, a small contrast leak from the transhepatic tract was seen. Three days later, pneumoperitoneum was found with symptoms of peritoneal irritation and fever. A widely open sphincter of Oddi caused by the metallic stent, accompanied by delayed sealing of the transhepatic tract, may have caused the air and bile leakage into the peritoneal space. This case shows that pneumoperitoneum may occur without ductal tear or bowel injury, with a biliary stent crossing the ampulla of Vater.
Full Text
https://link.springer.com/article/10.1007%2Fs002700010111
DOI
10.1007/s002700010111
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Radiology (영상의학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
Yonsei Authors
Yu, Jeong Sik(유정식) ORCID logo https://orcid.org/0000-0002-8171-5838
Lee, Se Joon(이세준) ORCID logo https://orcid.org/0000-0002-2695-2670
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/171590
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