담관 스텐트 삽입으로 치료한 췌장암에 의한 담즙종 1예 = Spontaneous Biloma Caused by Pancreatic Cancer and Treated by Endoscopic Biliary Stenting

다국어 초록 (Multilingual Abstract)

Biloma is a rare disorder, and is defined as an abnormal extrahepatic or intrahepatic collection of bile within a defined capsular space. The common causes of biloma are iatrogenic and trauma. Spontaneous biloma, especially caused by pancreatic cancer, is very rare. An 86-year-old man was admitted with abdominal pain and fever. The patient denied a history of abdominal surgery, endoscopic retrograde cholangiography, or trauma. Abdominal computed tomography demonstrated a huge collection of fluid in the left lobe of the liver, dilatation of the intra and proximal common bile duct, and a heterogeneous enhancing mass in the pancreatic head portion. Percutaneous drainage under ultrasound guidance was performed, and the fluid analysis was compatible with biloma. A plastic stent was endoscopically inserted into the common bile duct to treat continuous drainage of the fluid despite percutaneous drainage. We report a case of biloma developed spontaneously in a patient with pancreatic cancer and successfully treated by endoscopic biliary stenting.

국문 초록 (Abstract)

담즙종은 담즙이 담도 외로 누출되어 간내 또는 간외에 축척된 것으로 주로 수술이나 경피적 담관 조영술 등에 의한 의인성 담도 손상이나 외상에 의한 경우가 많지만 자발적으로 발생하는 경우는 매우 드물며, 특히 췌암암이 원인인 경우는 더욱 그러하다. 이전에 복부 수술이나 시술 또는 외상의 병력이 없었던 86세 남자 환자가 복통과 열감을 주소로 내원하였다. 복부CT에서 담즙종과 췌장 두부의 종괴가 발견되었고 경피 배액술을 시행하였다. 이후에도 다량의 담즙성 배액이 지속되어 ERCP를 하여 총담관에 스텐트를 삽입한 후 환자는 안정되었다. 저자들은 췌장암 환자에서 자발적으로 발생한 담즙종을 경피배액술과 내시경적 담관 스텐트 삽입을 통해 치료한 증례를 경험하여 문헌고찰과 함께 보고한다.

참고문헌 (Reference)

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