Novel case of percutaneous access of afferent limb of Roux-en-Y hepaticojejunostomy for biliary decompression and jejunoplasty in a patient with primary sclerosing cholangitis
| العنوان: | Novel case of percutaneous access of afferent limb of Roux-en-Y hepaticojejunostomy for biliary decompression and jejunoplasty in a patient with primary sclerosing cholangitis |
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| المؤلفون: | Marlon Coelho, Ryan Thibodeau, M. Jawed, Muhammad Osman Arif, Abtin Jafroodifar, Atin Goel |
| المصدر: | Radiology Case Reports Radiology Case Reports, Vol 15, Iss 12, Pp 2681-2686 (2020) |
| بيانات النشر: | Elsevier, 2020. |
| سنة النشر: | 2020 |
| مصطلحات موضوعية: | lcsh:Medical physics. Medical radiology. Nuclear medicine, Enteroscopy, medicine.medical_specialty, Percutaneous, Obstructive jaundice, lcsh:R895-920, medicine.medical_treatment, Case Report, Anastomosis, Liver transplantation, 030218 nuclear medicine & medical imaging, Primary sclerosing cholangitis, 03 medical and health sciences, 0302 clinical medicine, Interventional Radiology, Primary Sclerosing Cholangitis, Medicine, Ulcerative Colitis, Radiology, Nuclear Medicine and imaging, Percutaneous Balloon Dilatation, medicine.diagnostic_test, business.industry, Bile duct, Hepaticojejunostomy, Interventional radiology, medicine.disease, Roux-en-Y anastomosis, Surgery, medicine.anatomical_structure, business, 030217 neurology & neurosurgery |
| الوصف: | Primary sclerosing cholangitis is a rare condition characterized by multifocal fibrotic bile duct strictures and progressive liver disease. Due to its recurrence even after liver transplantation, an alternative surgical procedure, the Roux-en-Y hepaticojejunostomy, is practiced with positive outcomes. We present a case of a 55-year-old female with history of primary sclerosing cholangitis and Roux-en-Y hepaticojejunostomy approximately 25 years ago who presented to the emergency department with acute cholangitis. Computed tomography of the abdomen revealed a dilated loop of small bowel in the right upper quadrant and mid-abdomen with normal bile duct caliber. Interventional radiology was consulted for percutaneous biliary and Roux limb decompression. Ultrasound was utilized to identify and percutaneously access the dilated afferent jejunal limb. With the help of a T-fastener, the jejunal loop was tacked against the anterior abdominal wall and the system was successfully decompressed with a drain left in place. On follow-up, delayed contrast transit through the Roux limb and a stricture in the native jejunum distal to the anastomosis was identified. Hampering of the downstream flow of bile was noted and this was determined to be the likely cause of the initial episode of cholangitis. The strictured bowel segment was balloon-dilated by interventional radiology. Repeat injection of contrast revealed significant improvement in the caliber of the stenotic segment. At 3 weeks' postprocedure, a follow-up enteroscopy of the bowel was performed through the same percutaneous access site. Using this technique, the patient avoided a major invasive surgical procedure. |
| اللغة: | English |
| تدمد: | 1930-0433 |
| URL الوصول: | https://explore.openaire.eu/search/publication?articleId=doi_dedup___::2a3fec3718d628cd76a36a80e0c0697b http://europepmc.org/articles/PMC7581831 |
| حقوق: | OPEN |
| رقم الأكسشن: | edsair.doi.dedup.....2a3fec3718d628cd76a36a80e0c0697b |
| قاعدة البيانات: | OpenAIRE |
Full Text via ClinicalKey | تدمد: | 19300433 |
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