Öz
Pnömobili safra yollarında gaz birikmesidir.72 yaşında kadın hasta acil servise karın ağrısı ve genel durum yakınmaları ile başvurdu. Sağ lomber bölgede ağrı tanımlayan hastanın karın muayenesinde hafif distansiyon ve sağ hipokondriyak hassasiyet vardı. Kontrastsız abdominal tomografide karaciğerin sağ ve sol lob birleşim seviyesinde hipodens lezyon gözlendi. Ana safra kanalında ve intrahepatik safra kanallarında hava görünümü vardı. Hasta genel cerrahi yoğun bakım ünitesine yatırıldı. Abdominal görüntüleme ve karaciğer ince iğne aspirasyon biyopsisi sonucunda karaciğer apsesi saptandı. İki hafta süren yoğun bakım yatışı ve antibiyotik tedavisi sonrası hasta, regresyonun tamamen sağlanması ve genel durumun iyileşmesi nedeniyle oral antibiyotik tedavisi ile taburcu edildi. Pnömobili, mortalitesi yüksek nadir bir durumdur ve nedenleri arasında karaciğer apsesi de düşünülmelidir.
Anahtar Kelimeler
Kaynakça
- 1) Jin TY, Gaillard F, Pneumobilia, https://radiopaedia.org/articles/pneumobilia
- 2.Sherman SC, Tran H. Pneumobilia: benign or life-threatening. The Journal of emergency medicine, 2006;30(2):147-53.
- 3.Fourneau H, Grandjean C. Pneumobilia Caused by Blunt Abdominal Trauma. J Belg Soc Radiol, 2019;103(1):1.
- 4.Ladurner R, Kotsianos D, Mutschler W, Mussack T. Traumatic pneumobilia after cardiopulmonary resuscitation, European journal of medical research, 2005;10(11):495-7.
- 5.Keller M, Epp C, Meyenberger C, Sulz MC. Unspecific abdominal symptoms and pneumobilia: a rare case of gastrointestinal obstruction, Case reports in gastroenterology, 2014;8(2):216-20. Doi:10.1159/000364818.
- 6. Koulaouzidis A, Moschos J. Bouveret’s syndrome. Narrative review, Annals of hepatology, 2007;6(2):89-91.
- 7. Gonzaga ER, Bashir K, Bhatti H, Bracha A, Vishwas W. Liver Abscesses as a Complication of Side-to-Side Choledochoduodenostomy: 1283. American Journal of Gastroenterology, 2019;114:712-3.
- 8. Umgelter A, Wagner K, Gaa J et al. Pneumobilia Caused by a Clostridial Liver Abscess Rapid Diagnosis by Bedside Sonography in the Intensive Care Unit, J Ultrasound Med, 2007;26(9):1267-9.
- 9. Hart GB, Lamb RC, Strauss MB. Gazlı gangrene, J Trauma1983;23(11):991-1000.
Öz
Pneumobilia is the accumulation of gas in the biliary tract. A 72-year-old woman was brought tour emergency department with complaints of abdominal pain and general condition. The patient, who described pain in the right lumbar region, had mild distension and right hypochondriac tenderness during the abdominal examination. In contrast-free abdominal tomography, one hypodense lesion was observed at the right and left lobe junction level of the liver. There was an air view in the main bile duct and intra-hepatic bile ducts. The patient was admitted to the general surgery intensive care unit. Liver abscess was found as a result of abdominal imaging and liver fine needle aspiration biopsy performed. After a 2-week intensive care follow-up the patient was discharged with oral antibiotics due to the complete absence of regression and general condition of the patient. Pneumobilia is a rare condition with a high mortality and liver abscess should also be considered among its causes.
Anahtar Kelimeler
Kaynakça
- 1) Jin TY, Gaillard F, Pneumobilia, https://radiopaedia.org/articles/pneumobilia
- 2.Sherman SC, Tran H. Pneumobilia: benign or life-threatening. The Journal of emergency medicine, 2006;30(2):147-53.
- 3.Fourneau H, Grandjean C. Pneumobilia Caused by Blunt Abdominal Trauma. J Belg Soc Radiol, 2019;103(1):1.
- 4.Ladurner R, Kotsianos D, Mutschler W, Mussack T. Traumatic pneumobilia after cardiopulmonary resuscitation, European journal of medical research, 2005;10(11):495-7.
- 5.Keller M, Epp C, Meyenberger C, Sulz MC. Unspecific abdominal symptoms and pneumobilia: a rare case of gastrointestinal obstruction, Case reports in gastroenterology, 2014;8(2):216-20. Doi:10.1159/000364818.
- 6. Koulaouzidis A, Moschos J. Bouveret’s syndrome. Narrative review, Annals of hepatology, 2007;6(2):89-91.
- 7. Gonzaga ER, Bashir K, Bhatti H, Bracha A, Vishwas W. Liver Abscesses as a Complication of Side-to-Side Choledochoduodenostomy: 1283. American Journal of Gastroenterology, 2019;114:712-3.
- 8. Umgelter A, Wagner K, Gaa J et al. Pneumobilia Caused by a Clostridial Liver Abscess Rapid Diagnosis by Bedside Sonography in the Intensive Care Unit, J Ultrasound Med, 2007;26(9):1267-9.
- 9. Hart GB, Lamb RC, Strauss MB. Gazlı gangrene, J Trauma1983;23(11):991-1000.
Ayrıntılar
| Birincil Dil | İngilizce |
|---|---|
| Konular | Cerrahi, Klinik Tıp Bilimleri |
| Bölüm | Olgu Sunumu |
| Yazarlar | |
| Yayımlanma Tarihi | 30 Kasım 2020 |
| Gönderilme Tarihi | 29 Mayıs 2020 |
| Yayımlandığı Sayı | Yıl 2020 Cilt: 29 Sayı: 3 |