Clinical Endoscopy

The Korean Society of Gastrointestinal Endoscopy (대한소화기내시경학회)
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A Case of Acute Cholecystitis with a Perforation Complicating Endoscopic Retrograde Cholangiopancreatography

내시경 역행성 담췌관 조영술 후 발생된 천공을 동반한 급성 담낭염 1예

  • Ryu, Seung-Hee (Department of Internal Medicine, Dong-A University College of Medicine) ;
  • Noh, Myung-Hwan (Department of Internal Medicine, Dong-A University College of Medicine) ;
  • Han, Ji-Sun (Department of Internal Medicine, Dong-A University College of Medicine) ;
  • Woo, Su-Mi (Department of Internal Medicine, Dong-A University College of Medicine) ;
  • Kim, Byung-Geun (Department of Internal Medicine, Dong-A University College of Medicine) ;
  • Hsing, Chien-Ter (Department of Internal Medicine, Dong-A University College of Medicine) ;
  • Park, So-Young (Department of Internal Medicine, Dong-A University College of Medicine) ;
  • Kim, Joon-Mo (Department of Internal Medicine, Dong-A University College of Medicine)
  • 유승희 (동아대학교 의과대학 내과학교실) ;
  • 노명환 (동아대학교 의과대학 내과학교실) ;
  • 한지선 (동아대학교 의과대학 내과학교실) ;
  • 우수미 (동아대학교 의과대학 내과학교실) ;
  • 김병근 (동아대학교 의과대학 내과학교실) ;
  • 형건덕 (동아대학교 의과대학 내과학교실) ;
  • 박소영 (동아대학교 의과대학 내과학교실) ;
  • 김준모 (동아대학교 의과대학 내과학교실)
  • Published : 2011.03.30
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Abstract

The incidence of acute cholecystitis complicating endoscopic retrograde Cholangiopancreatography (ERCP) is rarely reported at 0.2% but is usually associated with a cystic duct obstruction caused by gallstones, gallbladder polyps, or cancer. However, acute cholecystitis with a gallbladder perforation after ERCP without a history of cystic duct obstruction can develop very rarely and has not yet been reported in Korea. We report a case of acute cholecystitis with gallbladder perforation and aggravation of a pancreatic pseudocyst after diagnostic ERCP in a man with a pancreatic cystic lesion. He has been successfully cured using only percutaneous transhepatic gallbladder drainage and antibiotics with no surgery.

내시경 역행성 담췌관 조영술 이후 발생한 담낭염은 아주 드물어 0.2% 정도로 보고하고 있으며, 이 경우도 대부분은 담낭 결석이나 담낭 용종, 암 등에 의한 담낭관의 폐쇄가 주원인이다. 하지만 담낭 결석이나 기타 담낭관 폐쇄 등의 선행 인자없이 내시경 역행성 담췌관 조영술 후에 천공을 동반한 급성 담낭염이 발생된 경우는 아주 드물며 국내에서는 보고된 예가 없다. 저자들은 가성 낭종을 동반한 급성 췌장염 환자에서 진단적 목적으로 내시경 역행성 담췌관 조영술을 시행한 후에 췌장 가성 낭종의 악화 및 담낭 축농과 천공이 동반된 급성 비결석 담낭염이 발생된 경우를 관찰하였으며 경피경간담낭배액술 및 항생제 요법으로 치료한 1예를 경험 하여 문헌고찰과 함께 보고한다.

Keywords

References

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