Development of Spontaneous Bacterial Peritonitis after Extended  Hepatic Resection in a Patient without Evidence of Liver Cirrhosis

곽민선; 이정훈; 김윤준; 윤정환; Hyo-Suk Lee

추천

검색

자료유형: 학술저널

저자정보: 곽민선 이정훈 김윤준 윤정환 Hyo-Suk Lee

저널정보: 거트앤리버 발행위원회 Gut and Liver Gut and Liver 제4권 제1호

발행연도: 2010.1

수록면: 129 - 134 (6page)

이용수

📌

연구주제

📖

연구배경

🔬

연구방법

🏆

연구결과

초록· 키워드

오류제보하기

Hilar cholangiocarcinomas are often treated with liver resections. Hepatic dysfunction and infection are common postoperative complications. Although secondary bacterial peritonitis due to abdominal abscess or perforation is common, we report herein the first case of spontaneous bacterial peritonitis after hepatic resection. A 61-year-old male patient without underlying liver disease was diagnosed as having a Klatskin tumor,and a right trisectionectomy with caudate lobectomy was performed. From postoperative days 18-28, the patient gained 4.1 kg as ascites developed, and showed evidence of hepatic insufficiency with prolonged prothrombin time and jaundice. Computed tomography,performed at postoperative day 28 when fever had developed, showed only ascites without bowel perforation or abscess. When paracentesis was performed, the serum-ascites albumin gradient was 2.3 g/dL, indicating portal hypertension, and the ascites’polymorphonuclear cell count was 1,156/mm3. Since the clinical, laboratory, and image findings were compatible with spontaneous bacterial peritonitis, we started empirical antibiotics without additional intervention. Follow-up analysis of the ascites after 48 hours revealed that the polymorphonuclear cell count had decreased markedly to 108/mm3; the fever and leukocytosis had also improved. After 2 weeks of antibiotic treatment, the patient recovered well, and was discharged without any problem.

#Spontaneous bacterial peritonitis #Hepatic resection #Cholangiocarcinoma

참고문헌 (24)

참고문헌 신청

Anthony SF / 1979 / Harrison's Principles of internal medicine. Volume 1. 17th ed / McGraw Hill : 808 ~ 809

Bac DV / 1996 / Spontaneous bacterial peritonitis complicating malignancy-related ascites / Dig Dis Sci 41 : 131 ~ 132

Belghiti J / 2000 / Seven hundred forty-seven hepatectomies in the 1990s: an update to evaluate the actual risk of liver resection / J Am Coll Surg 191 : 38 ~ 46

Bismuth H / 1992 / Management strategies in resection for hilar cholangiocarcinoma / Ann Surg 215 : 31 ~ 38

Chung RT / 2006 / Case records of the Massachusetts General Hospital: case 15-2006. A 46-year-old woman with sudden onset of abdominal distention / N Engl J Med 354 : 2166 ~

함께 읽어보면 좋을 논문

논문 유사도에 따라 DBpia 가 추천하는 논문입니다. 함께 보면 좋을 연관 논문을 확인해보세요!