1.Perforation of the Diaphragm Caused by Percutaneous Trans-Gallbladder Drainage Catheterization in a Patient with Primary Sclerosing Cholangitis
Mitsuru OKUNO ; Seiji ADACHI ; Yohei HORIBE ; Tomohiko OHNO ; Naoe GOTO ; Noriaki NAKAMURA ; Osamu YAMAUCHI ; Koshiro SAITO
Journal of the Japanese Association of Rural Medicine 2016;65(4):850-856
A 48-year-old man with jaundice was referred to our hospital. Endoscopic retrograde cholangiography showed primary sclerosing cholangitis. Endoscopic biliary drainage was not successful because of highly viscous bile, so we performed percutaneous trans-gallbladder drainage (PTGBD), which was able to reduce the total serum bilirubin level from 8 to 10mg/ml. Subsequently, an indwelling drainage catheter was placed in the gallbladder for 13 months. However, liver atrophy worsened with the gradual progression of hepatic failure. Twelve months later, he complained of dyspnea. Computed abdominal tomography showed that the drainage catheter had perforated the diaphragm and become exposed to the chest cavity. In spite of intensive care, the patient died of liver failure while waiting for a liver transplant. Careful attention should be paid to the possibility of this serious complication in such patients.
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