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Hyun Jin Bae 1 Article
A Rare Fatal Bile Peritonitis after Malposition of Endoscopic Ultrasound-Guided 5-Fr Naso-Gallbladder Drainage
Tae Hyung Kim, Hyun Jin Bae, Seung Goun Hong
Clin Endosc 2020;53(1):97-100.   Published online September 3, 2019
AbstractAbstract PDFPubReaderePub
Endoscopic ultrasound (EUS)-guided gallbladder (GB) drainage has recently emerged as a more feasible treatment than percutaneous transhepatic GB drainage for acute cholecystitis. In EUS-guided cholecystostomies in patients with distended GBs without pericholecystic inflammation or prominent wall thickening, a needle puncture with tract dilatation is often difficult. Guidewires may slip during the insertion of thin and flexible drainage catheters, which can also cause the body portion of the catheter to be unexpectedly situated and prolonged between the GB and intestines because the non-inflamed distended GB is fluctuant. Upon fluoroscopic examination during the procedure, the position of the abnormally coiled catheter may appear to be correct in patients with a distended stomach. We experienced such an adverse event with fatal bile peritonitis in a patient with GB distension suggestive of malignant bile duct stricture. Fatal bile peritonitis then occurred. Therefore, the endoscopist should confirm the indications for cholecystostomy and determine whether a distended GB is a secondary change or acute cholecystitis.


Citations to this article as recorded by  
  • Incidence and management of cystic duct perforation during endoscopic transpapillary gallbladder drainage for acute cholecystitis
    Kazunari Nakahara, Junya Sato, Ryo Morita, Yosuke Michikawa, Keigo Suetani, Yosuke Igarashi, Akihiro Sekine, Shinjiro Kobayashi, Takehito Otsubo, Fumio Itoh
    Digestive Endoscopy.2022; 34(1): 207.     CrossRef
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