A CASE OF BILIARY PERITONITIS DUE TO TRANSUDATION OF BILE FROM THE GALLBLADDER CAUSED BY PHLEOTHROMBOSIS

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  • 静脈血栓が原因と考えられた漏出性胆汁性腹膜炎の１例

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A 65-year-old man who was admitted to elsewhere because of abdominal pain after drinking alcohol was transferred to our hospital for exacerbating symptom. We started treatment with a suspicion of acute pancreatitis, but laboratory data showed increased inflammatory findings and massive ascites was seen. Aspiration of ascites yielded the diagnosis of bile peritonitis. We performed an emergency laparotomy, but could not find perforation of the gallbladder or intestine. We diagnosed him as having transudation of bile from the gallbladder and performed cholecystectomy and abdominal drainage. His postoperative course was uneventful. We found macroscopically thinning portions on serosa of the gallbladder, and pathologically necrotic changes in the muscle and serosa, but could not find necrotic changes in the mucous membrane of the gallbladder. Because stagnation and thrombosis in the vein of gallbladder wall were seen, it is etiologically supposed that failure of perfusion in the wall might lead to the transudation of bile juice.

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