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Management of Hemobilia with Transarterial Angiographic Embolization: Report of One Case

經動脈血管栓塞治療血膽道出血症:一病例報告

摘要


一位九歲女孩不小心被倒下之櫃子壓迫腹部,電腦斷層掃描發現肝裂傷及囊膜下出血。四天後突然發生腹絞痛及合併大量出血,緊急輸血及安排肝血管攝影顯示左肝動脈出血,同時進行了血管栓塞才止血。但病人仍併發了膽道瘻管及肝膿瘍。經兩次手術後才痊癒。肝挫傷或裂傷後引起膽出血在是小兒科少見之病例,其治療方式已由科手術改成非手術選擇性血管栓塞。本文就針對小血膽道症之治療做討論。

關鍵字

血膽道症 血管栓塞

並列摘要


A nine-year-old girl who developed life threatening hemobilia after blunt abdominal trauma was successfully managed by embolization of the hepatic artery aneurysm. However biliary fistula persisted and subcapsular liver abscess occurred after the endoscopic sphincterotomy and the placement of a nasobiliary drain for bile leakage. Debridement of the abscess and insertion of a drain tube eventually cured the event. The relevant literature is reviewed and the management of the hemobilia is discussed.

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