Dark green urine following endoscopic ultrasound-guided hepaticogastrostomy: A case report.

IF 5.4 3区 医学 Q1 GASTROENTEROLOGY & HEPATOLOGY
Ke-Yi Zhang, Qi He, Yu Jin, Jun Liu, Rong Lin, Chao-Qun Han
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引用次数: 0

Abstract

Background: Endoscopic ultrasound-guided biliary drainage, including endoscopic ultrasound-guided choledochoduodenostomy and endoscopic ultrasound-guided hepatogastrostomy (EUS-HGS), is an efficacious alternative to endoscopic retrograde cholangiopancreatography and its common complications are bile leak, infection, stent migration and bleeding. Here, we report an atypical case of a patient who developed unexplained dark green urine after receiving EUS-HGS, which we suspected to be caused by an abnormal biliary-vascular fistula.

Case summary: A 76-year-old woman diagnosed with pancreatic adenocarcinoma received EUS-HGS for relieving jaundice. The patient reported abdominal pain and chest tightness after the operation, with difficulty in urinating. X-ray suggested right-sided pleural effusion and dark green pleural effusion was drained out. However, the patient also developed dark green urine, which appeared everyday afternoon and disappeared automatically after intravenous treatment. The previous pleural effusion disappeared after one week, but later the patient showed an increase of ascites, and the lesions were compartmentalized and encapsulated internally.

Conclusion: Postoperative surveillance after EUS-HGS must be emphasized to check for in order to prevent severe and hidden complications.

超声内镜引导下肝胃造口术后出现深绿色尿液1例。
背景:超声内镜下胆道引流包括超声内镜下胆总管十二指肠吻合术和超声内镜下肝胃吻合术(EUS-HGS),是替代内镜下逆行胆管造影术的有效方法,其常见并发症为胆漏、感染、支架移位和出血。在这里,我们报告一个非典型病例,患者在接受EUS-HGS后出现不明原因的深绿色尿液,我们怀疑这是由异常的胆管瘘引起的。病例总结:一名诊断为胰腺腺癌的76岁女性接受EUS-HGS治疗黄疸。患者术后腹痛、胸闷、排尿困难。x线提示右侧胸腔积液及深绿色胸腔积液排出。但患者也出现深绿色尿液,每天下午出现,经静脉治疗后自动消失。先前的胸腔积液在一周后消失,但随后患者出现腹水增加,病变被区隔和内部包裹。结论:EUS-HGS术后应重视监测,以预防严重和隐蔽的并发症。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
World Journal of Gastroenterology
World Journal of Gastroenterology 医学-胃肠肝病学
CiteScore
7.80
自引率
4.70%
发文量
464
审稿时长
2.4 months
期刊介绍: The primary aims of the WJG are to improve diagnostic, therapeutic and preventive modalities and the skills of clinicians and to guide clinical practice in gastroenterology and hepatology.
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