Korean Journal of Gastrointestinal Endoscopy 2008;37(5): 389-392.
총담관 담석증 환자에서 심한 구토 후 관찰된 자발성 담도기종 1예
김세진ㆍ이경훈*ㆍ왕준호ㆍ이재동ㆍ설동춘ㆍ김승찬ㆍ김원학
건국대학교 의과대학 충주병원 내과학교실, *건국대학교병원 소화기병센터
A Spontaneous Pneumobilia Observed after Severe Vomiting in a Patient with CBD Stone
Se Jin Kim, M.D., Kyoung Hoon Rhee, M.D.*, Joon Ho Wang, M.D., Jae Dong Lee, M.D., Dong Chun Seol, M.D., Seung Chan Kim, M.D. and Won Hak Kim, M.D.
Department of Internal Medicine, Konkuk University College of Medicine, Chungju, *Digestive Disease Center, Konkuk University College of Medicine, Seoul, Korea
Abstract
Pneumobilia almost always indicates an abnormal communication between the biliary and gastrointestinal systems. Air may occasionally enter the biliary tract in a retrograde fashion through the papilla. Transient incompetence of the sphincter of Oddi, which is produced by the passage of small biliary stones, is one rare mechanism that can explain pneumobilia. We present here a case of spontaneous pneumobilia after sphincter disruption that was presumably caused by the passage of biliary stone. A 37-year-old woman visited our hospital with the symptom of right upper quadrant pain. The pain subsided after she had an episode of severe vomiting. Plain abdominal radiography revealed that air filled the branches of the hepatic ducts, and the common bile duct had a large filling defect. We also include a review of the related literature. (Korean J Gastrointest Endosc 2008;37:389-392)
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