ERCP後に消化管出血を来した総胆管結石の1例

概要

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A 64-year old man was admitted to our hospital with jaundice. Ultrasonography and computed tomography indicated the presence of common bile duct stones. The presence of stones was confirmed by endoscopic retrograde cholangiopancreato-graphy (ERCP) , and papillotomy was performed. Endoscopic retrograde nasobiliary drainage was initiated, and after one week an additional ERCP was performed. On this ERCP, coagula were found attached to the stomach wall. Lithotripsy was performed using basket forceps and all the stones were removed. The patient was also treated with a proton-pump inhibitor. However, four days after the second ERCP was performed, the patient's blood pressure markedly decreased and his hemoglobin concentration drropped to 4.8 mg/dl. During an emergency endoscopy, spurting-type bleeding from a gastric ulcer was noted, which was controlled by clipping. Subsequently, the patient recovered well and was discharged; thereafter, he visited our hospital regularly for follow-up examinations.
Japan Gastroenterological Endoscopy Society Kanto Chapterの論文