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Percutaneous transhepatic biliary drainage catheter fracture: A case report
Percutaneous transhepatic biliary drainage (PTBD) is safe treatment for biliary decompression given certain indications. However, this is temporary until definitive drainage is established. We report on a 76-year-old lady with recurrent pyogenic cholangitis and PTBD catheter fracture. She had hepati...
Autores principales: | , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
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Korean Association of Hepato-Biliary-Pancreatic Surgery
2018
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6125269/ https://www.ncbi.nlm.nih.gov/pubmed/30215051 http://dx.doi.org/10.14701/ahbps.2018.22.3.282 |
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author | Kwan, Jia Rui Low, Keith Sheng Hng Lohan, Rahul Shelat, Vishal G |
author_facet | Kwan, Jia Rui Low, Keith Sheng Hng Lohan, Rahul Shelat, Vishal G |
author_sort | Kwan, Jia Rui |
collection | PubMed |
description | Percutaneous transhepatic biliary drainage (PTBD) is safe treatment for biliary decompression given certain indications. However, this is temporary until definitive drainage is established. We report on a 76-year-old lady with recurrent pyogenic cholangitis and PTBD catheter fracture. She had hepatitis B virus-related Child-Pugh class A liver cirrhosis, hypothyroidism, hyperlipidaemia, and previous atrial fibrillation with a background of mild mitral, tricuspid and aortic valvular regurgitation. She had history of laparoscopic cholecystectomy in the past. She was deemed to be a high operative risk and declined hepatic resection. She had undergone multiple endoscopic and percutaneous biliary interventions to control sepsis and stone burden. A bilateral PTBD catheter was left in situ with plans for 3-monthly change. However, she defaulted follow-up and presented 11 months later with complaints of pain over the drain site and inability to flush the right catheter. Abdominal X-ray and computed tomography scans detected right catheter fracture at two places, making three fragments. She underwent percutaneous removal of the proximal fragment by an interventional radiology team. A temporary 4 Fr catheter was inserted to maintain biliary access. Endoscopic removal of the intra-biliary fragments was done the next day. Complete removal was confirmed on fluoroscopy. Finally, the 4 Fr catheter was replaced by a new 12 Fr catheter. The patient was discharged well. |
format | Online Article Text |
id | pubmed-6125269 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2018 |
publisher | Korean Association of Hepato-Biliary-Pancreatic Surgery |
record_format | MEDLINE/PubMed |
spelling | pubmed-61252692018-09-13 Percutaneous transhepatic biliary drainage catheter fracture: A case report Kwan, Jia Rui Low, Keith Sheng Hng Lohan, Rahul Shelat, Vishal G Ann Hepatobiliary Pancreat Surg Case Report Percutaneous transhepatic biliary drainage (PTBD) is safe treatment for biliary decompression given certain indications. However, this is temporary until definitive drainage is established. We report on a 76-year-old lady with recurrent pyogenic cholangitis and PTBD catheter fracture. She had hepatitis B virus-related Child-Pugh class A liver cirrhosis, hypothyroidism, hyperlipidaemia, and previous atrial fibrillation with a background of mild mitral, tricuspid and aortic valvular regurgitation. She had history of laparoscopic cholecystectomy in the past. She was deemed to be a high operative risk and declined hepatic resection. She had undergone multiple endoscopic and percutaneous biliary interventions to control sepsis and stone burden. A bilateral PTBD catheter was left in situ with plans for 3-monthly change. However, she defaulted follow-up and presented 11 months later with complaints of pain over the drain site and inability to flush the right catheter. Abdominal X-ray and computed tomography scans detected right catheter fracture at two places, making three fragments. She underwent percutaneous removal of the proximal fragment by an interventional radiology team. A temporary 4 Fr catheter was inserted to maintain biliary access. Endoscopic removal of the intra-biliary fragments was done the next day. Complete removal was confirmed on fluoroscopy. Finally, the 4 Fr catheter was replaced by a new 12 Fr catheter. The patient was discharged well. Korean Association of Hepato-Biliary-Pancreatic Surgery 2018-08 2018-08-31 /pmc/articles/PMC6125269/ /pubmed/30215051 http://dx.doi.org/10.14701/ahbps.2018.22.3.282 Text en Copyright © 2018 by The Korean Association of Hepato-Biliary-Pancreatic Surgery http://creativecommons.org/licenses/by-nc/4.0 This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited. |
spellingShingle | Case Report Kwan, Jia Rui Low, Keith Sheng Hng Lohan, Rahul Shelat, Vishal G Percutaneous transhepatic biliary drainage catheter fracture: A case report |
title | Percutaneous transhepatic biliary drainage catheter fracture: A case report |
title_full | Percutaneous transhepatic biliary drainage catheter fracture: A case report |
title_fullStr | Percutaneous transhepatic biliary drainage catheter fracture: A case report |
title_full_unstemmed | Percutaneous transhepatic biliary drainage catheter fracture: A case report |
title_short | Percutaneous transhepatic biliary drainage catheter fracture: A case report |
title_sort | percutaneous transhepatic biliary drainage catheter fracture: a case report |
topic | Case Report |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6125269/ https://www.ncbi.nlm.nih.gov/pubmed/30215051 http://dx.doi.org/10.14701/ahbps.2018.22.3.282 |
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