Perforation of the Diaphragm Caused by Percutaneous Trans-Gallbladder Drainage Catheterization in a Patient with Primary Sclerosing Cholangitis

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  • 長期間経皮経肝胆嚢ドレナージカテーテル留置により横隔膜穿孔をきたした１例
  • 症例報告 長期間経皮経肝胆嚢ドレナージカテーテル留置により横隔膜穿孔をきたした1例
  • ショウレイ ホウコク チョウキカン ケイヒケイ カンタンノウ ドレナージカテーテル リュウチ ニ ヨリ オウカクマク センコウ オ キタシタ 1レイ

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A 48-year-old man with jaundice was referred to our hospital. Endoscopic retrograde cholangiography showed primary sclerosing cholangitis. Endoscopic biliary drainage was not successful because of highly viscous bile, so we performed percutaneous trans-gallbladder drainage (PTGBD), which was able to reduce the total serum bilirubin level from 8 to 10mg/ml. Subsequently, an indwelling drainage catheter was placed in the gallbladder for 13 months. However, liver atrophy worsened with the gradual progression of hepatic failure. Twelve months later, he complained of dyspnea. Computed abdominal tomography showed that the drainage catheter had perforated the diaphragm and become exposed to the chest cavity. In spite of intensive care, the patient died of liver failure while waiting for a liver transplant. Careful attention should be paid to the possibility of this serious complication in such patients.

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