Endoscopic-catheter-directed infusion of diluted(-)-noradrenaline for atypical hemobilia caused by liver abscess:A case report  

作　　者：Hong Zou Yi Wen Yong Pang Hui Zhang Lin Zhang Li-Jun Tang Hong Wu 

机构地区：[1]Department of Liver Surgery&Liver Transplantation,State Key Laboratory of Biotherapy and Cancer Center,West China Hospital,Sichuan University and Collaborative Innovation Center of Biotherapy,Chengdu 610044,Sichuan Province,China [2]Department of General Surgery&Pancreatic Injury and Repair Key Laboratory of Sichuan Province,The General Hospital of Western Theater Command(Chengdu Military General Hospital),Chengdu 610083,Sichuan Province,China

出　　处：《World Journal of Clinical Cases》2022年第10期3306-3312,共7页世界临床病例杂志

基　　金：Supported by the National Clinical Key Subject of China,No. 41732113

摘　　要：BACKGROUND Hemobilia occurs when there is a fistula between hepatic blood vessels and biliary radicles,and represents only a minority of upper gastrointestinal hemorrhages.Causes of hemobilia are varied,but liver abscess rarely causes hemobilia and only a few cases have been reported.Here,we present a case of atypical hemobilia caused by liver abscess that was successfully managed by endoscopic hepatobiliary intervention through endoscopic retrograde cholangiopancreatography(ERCP).CASE SUMMARY A 54-year-old man presented to our emergency department with a history of right upper quadrant abdominal colic and repeated fever for 6 d.Abdominal sonography and enhanced computed tomography revealed that there was an abscess in the right anterior lobe of the liver.During hospitalization,the patient developed upper gastrointestinal bleeding.Upper gastrointestinal endoscopy revealed a duodenal ulcer bleeding that was treated with three metal clamps.However,the hemodynamics was still unstable.Hence,upper gastrointestinal endoscopy was performed again and fresh blood was seen flowing from the ampulla of Vater.Selective angiography did not show any abnormality.An endoscopic nasobiliary drainage(ENBD)tube was inserted into the right anterior bile duct through ERCP,and subsequently cold saline containing(-)-noradrenaline was infused into the bile duct lumen through the ENBD tube with no episode of further bleeding.CONCLUSION Hemobilia should be considered in the development of liver abscess,and endoscopy is essential for diagnosis and management of some cases.

关 键 词：HEMOBILIA Liver abscess NORADRENALINE Endoscopic retrograde cholangiopancreatography Case report 

分 类 号：R657.4[医药卫生—外科学]