头孢曲松钠所致胆囊假性结石的CT影像诊断

CT imaging diagnosis of gallbladder pseudolithiasis caused by Ceftriaxone

目的探讨静脉使用头孢曲松钠后产生胆囊假性结石的CT影像表现。方法回顾性分析我院22例住院病人在静脉使用头孢曲松钠后胆囊出现假性结石的CT表现。结果头孢曲松钠所致胆囊假性结石形成最早出现在用药后20小时,最迟7天,平均4天;假性结石在停药后均自行消失,消失时间最早为停药后第3天,最迟6个月,其中20例在2个星期内消失。22例中18例表现为泥沙样胆囊假性结石,占81.8%,其中1例儿童患者合并泌尿系结石;3例表现为块状假性结石;1例为石灰样胆汁样改变。结论静脉使用头孢曲松钠后会产生胆囊假性结石,停药后短期内可恢复正常,临床及影像医生应对此有所认识,以免给病人带来不必要的手术干预。

Objective To investigate the CT imaging features of gallbladder pseudolithiasis caused by the therapy of eefiriaxone. Methods The CT appearances of gallbladder pseudolithiasis in the intravenous use of Ceftriaxone in 22 cases were retrospectively analyzed. Results Gallbladder pseudo]ithiasis associated with ceftriaxone appeared earliest at 20 hours after intravenous use of Cefiriaxone, latest at seven days, average of four days. Gallbladder pseudolithiasis disappeared after cessation of therapy, pseudolithiasis disappeared earliest at three days, latest at six months, of which, 20 cases gallbladder pseudolithiasis disappeared in two weeks; 18 cases gallbladder pseudolithiasis showed sand-like calculi （accounting for 81.8 percent）; one child patient developed urinary calculi; three cases appeared patchy stone; 1 case showed lime-like bile. Conclusion The use of intravenous ceftriaxone can caused gallbladder pseudolithiasis. After stopping to use for a short period , the patient can return to normal. Clinical and imaging doctors should be on high alert as not to cause unnecessary suffering and operation to patients.