The Korean Journal of Medicine

The Korean Association of Internal Medicine (대한내과학회)
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Portal Vein Cannulation During Endoscopic Retrograde Cholangiopancreatography

내시경역행성췌담도조영술 중 발생한 간문맥 내 삽관 1예

  • Kim, Chang Lae (Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine) ;
  • Ha, Yeonjung (Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine) ;
  • Om, Sang Yong (Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine) ;
  • Ji, Wonjun (Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine) ;
  • Kim, Tae Oh (Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine) ;
  • Choi, Jun-Ho (Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine) ;
  • Kim, Myung-Hwan (Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine)
  • 김창래 (울산대학교 의과대학 서울아산병원 내과) ;
  • 하연정 (울산대학교 의과대학 서울아산병원 내과) ;
  • 엄상용 (울산대학교 의과대학 서울아산병원 내과) ;
  • 지원준 (울산대학교 의과대학 서울아산병원 내과) ;
  • 김태오 (울산대학교 의과대학 서울아산병원 내과) ;
  • 최준호 (울산대학교 의과대학 서울아산병원 내과) ;
  • 김명환 (울산대학교 의과대학 서울아산병원 내과)
  • Received : 2013.06.14
  • Accepted : 2013.07.01
  • Published : 2014.04.01
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Abstract

A 68-year-old woman was admitted to our hospital with obstructive jaundice. Abdominal CT scan demonstrated a mass at the head of the pancreas. The patient was diagnosed as having obstructive jaundice caused by pancreatic cancer. We tried to relieve the bile duct obstruction by ERCP (endoscopic retrograde cholangiopancreatography). After several cannulation attempts, we thought that we had achieved deep cannulation of the bile duct and tried to place a biliary plastic stent. During ERCP, however, we noticed massive air in the portal venous system, indicating possible cannulation of the portal vein. The procedure was terminated immediately and abdominal computed tomography revealed air in the portal venous system. Fortunately, there were no subsequent complications. The air in the portal vein had disappeared, ascertained by CT scan taken 5 days later. The patient underwent surgical resection for pancreatic cancer. Isolated portal vein cannulation per se does not usually result in mortality or serious morbidity.

국내에서 내시경역행성췌담도조영술 시행 중 간문맥 삽관이 보고된 증례는 없었다. 황달이 발생한 췌장 두부암 환자에서 내시경역행성췌담도조영술 중 유도선을 따라 삽관 캐뉼라를 삽입하였으나 간문맥 내 삽관이 발생하여 시술을 중단하고 보존적 치료를 통하여 회복된 증례를 경험하였기에 문헌고찰과 함께 보고하는 바이다.

Keywords

References

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