A 77-year-old man underwent percutaneous transhepatic gallbladder drainage(PTGBD) for acute cholecystitis as a preoperative procedure;however,he suddenly suffered cardiopulmonary arrest 4 h after the PTGBD and died.Th...A 77-year-old man underwent percutaneous transhepatic gallbladder drainage(PTGBD) for acute cholecystitis as a preoperative procedure;however,he suddenly suffered cardiopulmonary arrest 4 h after the PTGBD and died.There were three centesis scars for the PTGBD,and only one pathway from the most dorsal centesis scar reached the gallbladder.Microscopically,the PTGBD pathway crossed and injured the intrahepatic arterial wall,and hepatic parenchymal bleeding extended along the PTGBD pathway to the inferior surface of the liver.Blood flowed to the peritoneal cavity through a small gap between the liver and gallbladder.Consequently,the PTGBD caused lethal bleeding.When the percutaneous transhepatic cholangio drainage/PTGBD pathway runs close to vessels near the liver surface,it might be necessary to deal with the possibility of rapid and lethal peritoneal bleeding.展开更多
A primary aortoenteric fistula (PAEF), defined as a communication between the native aorta and the gastrointestinal tract, is a rare cause of gastrointes-tinal bleeding. The preoperative diagnosis of PAEF is extremely...A primary aortoenteric fistula (PAEF), defined as a communication between the native aorta and the gastrointestinal tract, is a rare cause of gastrointes-tinal bleeding. The preoperative diagnosis of PAEF is extremely difficult. Consequently, PAEF may cause sudden and unexpected death. We present an autopsy case of a 68-year-old man who died of massive gastro-intestinal bleeding due to a PAEF. Autopsy revealed a pinhole rupture located on the third part of the duode-nal mucosa and fistulized into the adjacent abdominal aortic aneurysm (AAA). Our case indicates that the aortoenteric fistula can result in fatal gastrointestinal bleeding. Consequently, a PAEF should be included in the differential diagnosis of gastrointestinal bleeding.展开更多
文摘A 77-year-old man underwent percutaneous transhepatic gallbladder drainage(PTGBD) for acute cholecystitis as a preoperative procedure;however,he suddenly suffered cardiopulmonary arrest 4 h after the PTGBD and died.There were three centesis scars for the PTGBD,and only one pathway from the most dorsal centesis scar reached the gallbladder.Microscopically,the PTGBD pathway crossed and injured the intrahepatic arterial wall,and hepatic parenchymal bleeding extended along the PTGBD pathway to the inferior surface of the liver.Blood flowed to the peritoneal cavity through a small gap between the liver and gallbladder.Consequently,the PTGBD caused lethal bleeding.When the percutaneous transhepatic cholangio drainage/PTGBD pathway runs close to vessels near the liver surface,it might be necessary to deal with the possibility of rapid and lethal peritoneal bleeding.
文摘A primary aortoenteric fistula (PAEF), defined as a communication between the native aorta and the gastrointestinal tract, is a rare cause of gastrointes-tinal bleeding. The preoperative diagnosis of PAEF is extremely difficult. Consequently, PAEF may cause sudden and unexpected death. We present an autopsy case of a 68-year-old man who died of massive gastro-intestinal bleeding due to a PAEF. Autopsy revealed a pinhole rupture located on the third part of the duode-nal mucosa and fistulized into the adjacent abdominal aortic aneurysm (AAA). Our case indicates that the aortoenteric fistula can result in fatal gastrointestinal bleeding. Consequently, a PAEF should be included in the differential diagnosis of gastrointestinal bleeding.
