Home | Register | Login | Inquiries | Alerts | Sitemap |  


Advanced Search
JKM > Volume 43(3); 2022 > Article
Lee, Park, Cho, Son, and Lee: A case report of gastrointestinal perforation in patient after biliary stent insertion and the overview of gastrointestinal perforation

Abstract

Objectives

This study aimed to emphasize the importance of accurate and timely diagnosis of acute abdominal pain with simple radiography by reporting a case of gastrointestinal perforation.

Methods

We closely observed the diagnosis and progress of acute abdominal pain after biliary stent and reviewed the outline of gastrointestinal perforation.

Results

Patient diagnosed with urethral cancer metastasis to lung and peritoneum was treated with complex Korean medicinal treatments to deal with anorexia, abdominal pain, jaundice and oliguria. During hospitalization, the patient’s acute abdominal pain after biliary stent was diagnosed with gastrointestinal perforation by using plain chest and abdominal radiography.

Conclusion

Using simple radiography to find out the emergency diseases such as perforation in acute abdominal pain is important clinically.

Fig. 1
Computed Tomography(CT) at diagnosis (2019.02.21.) A: Abdomen CT, B: Chest CT
jkm-43-3-195f1.gif
Fig. 2
Summary of treatment course.
jkm-43-3-195f2.gif
Fig. 3
Changes of LFT and bilirubin after PTBD
jkm-43-3-195f3.gif
Fig. 4
Changes of vital sign and patient’s progress
jkm-43-3-195f4.gif
Fig. 5
Simple X-rays when diagnosed with perforation (2019.03.29)
A: Chest X-ray B: Abdomen S/E
jkm-43-3-195f5.gif
Table 1
Biochemical data of the patient
Parameter 2019-03-11 2019-03-15 2019-03-28
AST(IU/L) 158 162 60
ALT(IU/L) 69 80 22
ALP(IU/L) 279 292 164
Total bilirubin(mg/dL) 3.65 5.71 2.57
Direct bilirubin(mg/dL) 2.8 4.7 1.8
Table 2
Changes of vital sign during administration period
Parameter Blood pressure Pulse rate Body temperature
03-28 02:00 120/70 90 37.1
03-28 06:00 120/70 63 37.1
03-28 10:00 120/70 82 37
03-28 14:00 120/70 86 36.5
03-28 18:00 120/80 76 36.7
03-28 21:00 130/70 90 36.5
03-29 02:00 140/80 84 36.9
03-29 06:00 130/80 91 36.9
03-29 10:00 120/80 96 37

03-29 14:00 130/80 105 36.4

참고문헌

1. Brewer B.J., Golden G.T., Hitch D.C., Rudolf S.L.; Abdominal pain. 1976; An analysis of 1,000 consecutive cases in a University Hospital emergency room. Am J Surg. 131:219–23. 10.1016/0002-9610(76)90101-x
crossref pmid

2. Powers R.D., Guertler A.T.1995; Abdominal pain in the ED: stability and change over 20 years. Am J Emerg Med. 13:301–3. 10.1016/0735-6757(95)90204-X
crossref pmid

3. Jong W.C., Joo Y.S., Hong K., Chang S.R., Sung M.L., Yang G.J., et al1997; The Value of CT in Detecting Pathologic Bowel Perforation. J Korean Radiol Soc. 37:697–702.
crossref

4. Kwack H.J., Kim K.M., Kim M.H., Jin G.Y., Chung M.J.2011; Pneumatosis intestinalis and Intestinal perforation related to Rapid Response during Sunitinib Therapy for Gastrointestinal stromal tumor. The Chonbuk Univ Med J. 35:1. 39–43.


5. Oh J.H., Lee I.S.2007; Image of The Month: Enterovesical Fistula and Intestinal Perforation Complicated by Crohn’s Disease. The Korean J Gastroenterol. 49:4. 199–200.
pmid

6. Choi W.Y., Choi J.Y., Lee J.H., Seo C.J., Park K.W., Park S.H., et al2007; Remission of Refractory Intestinal Behcet’s Disease with Infliximab. J Rheum Dis. 14:1. 61–5.
crossref

7. Kim M.H., Lee S.S., Park D.H., Lee S.K., Kim H.J., Seo D.W., et al2011; Case Report: Three Cases of Successful Treatment of Iatrogenic Duodenal Perforation. The Korean J Gastrointestinal Endoscopy. 42:1. 57–61.


8. Tanner T.N., Hall B.R., Oran J.2018; Pneumoperitoneum. Surg. Clin. North Am. 98:5. 915–32. 10.1016/j.suc.2018.06.004
crossref pmid

9. Mayumi T., Yoshida M., Tazuma S., Furukawa A., Nishii O., Shigematsu K., et al2016; The Practice Guidelines for Primary Care of Acute Abdomen 2015. Jpn J Radiol. 34:1. 80–115. 10.1007/s11604-015-0489-z26678269.
pmid

10. Stapfer M., Selby R.R., Stain S.C.2000; Management of duodenal perforation after endoscopic retrograde cholangiopancreatography and sphincterotomy. Ann Surg. 232:191–8. 10.1097/00000658-200008000-00007
crossref pmid pmc

11. Enns R., Eloubeidi M.A., Mergener K., Jowell P.S., Branch M.S., Pappas T.M., et al2002; ERCP-related perforations: risk factors and management. Endoscopy. 34:293–8. 10.1055/s-2002-23650
crossref pmid

12. Kumar A., Muir M.T., Cohn S.M., Salhanick M.A., Lankford D.B., Katabathina V.S.2012; The etiology of pneumoperitoneum in the 21st century. J Trauma Acute Care Surg. 73:542–8. 10.1097/TA.0b013e31825c157f
crossref pmid

13. Levine M.S., Scheiner J.D., Rubesin S.E., Laufer I., Herlinger H.1991; Diagnosis of pneumoperitoneum on supine abdominal radiographs. AJR Am J Roentgenol. 156:731–5. 10.2214/ajr.156.4.2003436
crossref pmid

14. Stapakis J.C., Thickman D.1992; Diagnosis of pneumoperitoneum: abdominal CT vs. upright chest film. J Comput Assist Tomogr. 16:5. 713–6.
pmid

15. Park J.M., Yoon Y.H., Horeczko T., Kaji A.H., Lewis R.J.2017; Changes of Clinical Practice in Gastrointestinal Perforation with the Increasing Use of Computed Tomography. J Korean Soc Traumatol. 30:2. 25–32.
crossref

16. Damore L.J., Rantis P.C., Vernava A.M., Longo W.E.1996; Colonoscopic perforations. Etiology, diagnosis, and management. Dis Colon Rectum. 39:11. 1308–14. 10.1007/BF02055129
crossref pmid

17. Cai S.L., Chen T., Yao L.Q., Zhong Y.S.2015; Management of iatrogenic colorectal perforation: From surgery to endoscopy. World J Gastrointest Endosc. 7:8. 819–23. 10.4253/wjge.v7.i8.819
crossref pmid pmc

18. Park J.W., Yoon J., Cho C.K., Lee Y.W., Yoo H.S.2014; Survival analysis of stage IV metastatic gastric cancer patients treated with HangAm-Plus. Chin J Integr Med. 20:1. 49–55. 10.1007/s11655-012-1084-0
pmid

19. Khan N., Afaq F., Syed D.N., Mukhtar H.2008; Fisetin, a novel dietary flavonoid, causes apoptosis and cell cycle arrest in human prostate cancer LNCaP cells. Carcinogenesis. 29:5. 1049–56. 10.1093/carcin/bgn078
crossref pmid pmc

20. Suh Y., Afaq F., Johnson J.J., Mukhtar H.2009; A plant flavonoid fisetin induces apoptosis in colon cancer cells by inhibition of COX2 and Wnt/EGFR/NF-kappaB-signaling pathways. Carcinogenesis. 30:2. 300–7. 10.1093/carcin/bgn269
crossref pmid pmc

21. Yim M.H., Shin J.W., Son J.Y., Oh S.M., Han S.H., Cho J.H., et al2007; Soluble components of Hericium erinaceum induce NK cell activation via production of interleukin-12 in mice splenocytes. Acta Pharmacol Sin. 28:6. 901–907. 2007; 10.1111/j.1745-7254.2007.00577.x
crossref pmid

22. Lee G.Y., Park C.R., Cho J.H., Son C.G., Lee N.H.2020; The Effect of Chunggan Plus Extract in Improving Liver Function: A Retrospective Case Series of Eight Patients. J Int Korean Med. 41:3. 542–51. http://dx.doi.org/10.22246/jikm


23. Srinivasan I., Kahaleh M.2011; Biliary stents in the millennium. Adv Ther. 28:11. 960–72. 10.1007/s12325-011-0067-4
pmid

24. Mady R.F., Niaz O.S., Assal M.M.2015; Migrated biliary stent causing perforation of sigmoid colon and pelvic abscess. BMJ Case Rep. 2015; bcr201420680510.1136/bcr-2014-206805
crossref pmid

25. Eisenberg R.L., Heineken P., Hedgcock M.W., Federle M., Goldberg H.I.1983; Evaluation of plain abdominal radiographs in the diagnosis of abdominal pain. Ann Surg. 197:4. 464–9. 10.1097/00000658-198304000-00016
crossref pmid pmc

TOOLS
PDF Links  PDF Links
Full text via DOI  Full text via DOI
PubReader  PubReader
Download Citation  Download Citation
  Print
Share:      
METRICS
0
Crossref
132
View
5
Download
Editorial office contact information
3F, #26-27 Gayang-dong, Gangseo-gu Seoul, 157-200 Seoul, Korea
The Society of Korean Medicine
Tel : +82-2-2658-3627   Fax : +82-2-2658-3631   E-mail : skom1953.journal@gmail.com
About |  Browse Articles |  Current Issue |  For Authors and Reviewers
Developed in M2PI