Korean J Gastrointest Endosc > Volume 14(3); 1994 > Article
Korean Journal of Gastrointestinal Endoscopy 1994;14(3): 380-385.
증례 : 화농성 심낭염 , 간농양 및 농흉을 야기한 총담관 거대결석 치유 1예 ( Case Reports : A Case of Large Bile Duct Stones Complicated by Pyogenic Pericarditis , Liver Abscess , and Pyothorax )
최호순, 박강서, 최덕례, 고정희, 최우석, 안진형, 조병석, 박병수 (Ho Soon Choi, Kang Seo Park, Duck Reii Choi, Jung Hee Kho, Woo Seok Choi, Jin Hyung Ahn, Byoung Seok Cho and Byoung Soo Park)
Abstract
The complications of bile duct stone are cholangitis, pancreatitis, obstructive jaundice, liver abscess, and secondary biliary cirrhosis. Liver abscess may produce pyothorax, peritonitis, subphrenic abscess, and pyogenic pericarditis. The case studies of pyogenic pericarditis secondary to pyogenic liver abscess are rarely reported. Stones greater than 20mm in diameter are difficult or impossible to remove with a standard basket or balloon after sphincterotomy. There are several nonsurgical treatment options for large bile duct stone: mechanical lithotripsy, endoprosthesis, extracorporeal shock-wave lithotripsy (ESWL), electrohydraulic lithotripsy, contact dissolution therapy, and laser lithotripsy. We experienced a case of large bile duct stone which complicated by pyogenic pericarditis, liver abscess, and pyothorax. He treated with antibiotics, closed thoracostomy, partial pericardiectomy, and removal of bile duct stones by extracorporeal shock-wave and mechanical lithotripsy after endoscopic sphincterotomy and nasobiliary drainage.
Key Words: Pyogenic pericarditis , Liver abscess , Empyema , Complication , Large bile duct stone
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