title: [Hemobilia after percutaneous transhepatic gallbladder drainage for cholecystitis in a patient undergoing aortic valve replacement].
abstract: A 50-year-old man with hemobilia after percutaneous transhepatic gallbladder drainage (PTGBD) for cholecystitis is presented. PTGBD had been performed for acute cholecystitis following aortic valve replacement. A combination of aspirin and warfarin as anticoagulant therapy had been administrated with the prothrombin time of approximate 40%. Six months later, the patient was again admitted to our hospital because of jaundice, high fever and digestive bleeding. PTGBD was again attempted under the diagnosis of acute cholecystitis. Endoscopic retrograde cholangiopancreatography revealed coagula which were excreted from the papilla of Vater, thus followed by a cholecystectomy accompanying with a choledochotomy. Three ulcers were observed in the cut surface of the resected gallbladder. Microscopic examinations of the gallbladder showed hemorrhage and inflammation. We reported out patient because hemobilia in the chronic phase after aortic valve replacement is rare.
authors.affiliation: Second Department of Surgery, Gunma University School of Medical, Japan.
authors.forename: K
authors.initials: K
authors.lastname: Tago
authors.forename: S
authors.initials: S
authors.lastname: Ohwada
authors.forename: S
authors.initials: S
authors.lastname: Nakamura
authors.forename: Y
authors.initials: Y
authors.lastname: Kawashima
authors.forename: S
authors.initials: S
authors.lastname: Ishikawa
authors.forename: Y
authors.initials: Y
authors.lastname: Morishita
mesh_terms: D000208:Acute Disease; D001021:Aortic Valve / Q000601:surgery; D001022:Aortic Valve Insufficiency / Q000601:surgery*; D002764:Cholecystitis / Q000209:etiology / Q000601:surgery*; D004322:Drainage / Q000379:methods*; D006350:Heart Valve Prosthesis / Q000009:adverse effects*; D006431:Hemobilia / Q000209:etiology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications