Two Cases of Acute Cholecystitis in which Percutaneous Transhepatic Gallbladder Aspiration(PTGBA) was Useful.
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概要
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We report 2 patients with acute cholecystitis for which percutaneous transhepatic gallbladder aspiration (PTGBA) was useful. In Case 1, the patient was a 75-year-old woman who experienced a sudden onset of back pain and upper abdominal pain at night. Abdominal ultrasound (US) showed enlargement of the gallbladder with thickening of the wall, a sonolucent layer, and a stone in the neck of the gallbladder, which led to a diagnosis of acute cholecystitis. Magnetic resonance imaging (MRI) demonstrated thickening of the gallbladder wall and 2 areas of low-intensity signal. The pain and fever persisted, for which we performed PTGBA, aspirating about 113 ml of infected bile. Subsequently, the pain and fever subsided, and abdominal US revealed a reduction in the enlargement of the gallbladder with the persistence of thickening of the wall. On the eighth day after PTGBA, open abdominal cholecystectomy was performed. In Case 2, the patient was a 56-year-old woman who had right hypochondriac pain after supper. The pain gradually increased in severity. Abdominal US showed enlargement of the gallbladder with a thickened wall, a sonolucent layer, and a gallstone in the neck of the gallbladder, which led to a diagnosis of acute cholecystitis. Magnetic resonance cholangiopancreatography (MRCP) showed enlargement of the gallbladder with no abnormalities in the common bile duct. After admission to hospital, the pain and fever persisted, for which we performed PTGBA, aspirating about 50 ml of infected bile. Subsequently, the pain and fever vanished. Abdominal US revealed a reduction in the enlargement of the gallbladder with the persistence of thickening of the wall. On the seventh day after PTGBA, laparoscopic cholecystectomy was performed. PTGBA seems useful for early alleviation of the symptoms of acute cholecystitis because of low invasiveness and ease of performance.
- 久留米大学医学部 The Kurume Medical Journal 編集部の論文
著者
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AOYAGI Shigeaki
Department of Cardiovascular Surgery, Kurume University School of Medicine
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Okuda Koji
Department Of Electrical Engineering Faculty Of Engineering Science Osaka University:on Leave Of Abs
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YASUNAGA MASAFUMI
Department of Surgery, Kurume University School of Medicine
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Odo Masaharu
Department Of Surgery Kurume University School Of Medicine
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Tamae Tsuyoshi
Department Of Surgery And Division Of Hepatic Surgery Kurume University School Of Medicine
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Shirouzu Kazuo
Department Of Surgery Kurume University
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Kodama Takahito
Department Of Surgery Kurume University Medical Center
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Furukawa Satoshi
Department Of Aquatic Bioscience Graduate School Of Agricultural And Life Sciences The University Of
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Yasunaga Masafumi
Department Of Anatomic Pathology Kyushu University Hospital
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Nishimura Kazunori
Department Of Cardiovascular Surgery Nagano Red Cross Hospital
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Matsuo Hideki
Department Of Surgery Kurume University School Of Medicine
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Kinoshita Hisafumi
Department Of Surgery And Oncology Graduate School Of Medical Sciences Kyushu University
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Hamada Shigeru
Department Of Artificial Organs Research Institute National Cerebral And Cardiovascular Center
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Hashimoto Mitsuo
Department of Chemistry Faculty of Arts and Sciences Ibaraki University
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Hara Masao
Department of Industrial Chemistry, Faculty of Engineering, Yamaguchi University
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HAMADA Shigeru
Deparment of Mechanical Engineering, Kyushu University
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SHIROUZU KAZUO
Department of Gastroenterology and Surgery, Kurume University School of Medicine
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