내시경 역행 담췌관조영술 후 발생한 급성 비결석성 담낭염 1예 = A Case of Acute Acalculous Cholecystitis Complicating Endoscopic Retrograde Cholangiopancreatography

다국어 초록 (Multilingual Abstract)

Endoscopic retrograde cholangiopancreatography (ERCP) has gained wide acceptance as a valuable tool for the diagnosis and management of disease of the pancreas and biliary tract. Complications associated with ERCP include bleeding, perforation, pancreatitis, and cholangitis, and the incidence is about 5∼10%. Acute acalculous cholecystitis can be developed rarely after ERCP. It tends to have more complicated course, resulting in higher morbidity and mortality. We report a case of acute acalculous cholecystitis complicating therapeutic ERCP in a 52-year-old man with primary common bile duct stone. He underwent open cholecystectomy because of uncontrolled infection and rapid progression to septic shock. Although acute acalculous cholecystitis is one of rare complications developed after ERCP, it should be considered as one of the differential diagnosis in patients who complain of abdominal pain after ERCP because of high mortality rate and the need for prompt surgical management.

국문 초록 (Abstract)

내시경 역행 담췌관조영술(ERCP)은 췌장 또는 담도 질환에 있어 진단 및 치료를 목적으로 널리 사용되고 있는 유용한 검사 방법이다. ERCP와 관련된 합병증은 발생 빈도가 낮고 대부분 경미하나, 드물게는 급성 비결석성 담낭염과 같은 생명을 위협할 만한 중증의 합병증이 발생할 수 있어 시술 후에도 면밀한 관찰을 요한다. 저자들은 52세 남자가 간헐적인 우상복부 통증을 호소하여 시행한 내시경초음파검사에서 총담관결석을 진단하고 결석을 제거하기 위해 시행한 ERCP 후 합병증으로, 담낭 경부의 선종성 용종이 역류저지판막 역할을 해서 담즙 및 조영제가 배액되지 않아 급성 비결석성 담낭염이 발생하였고 이후 환자가 급속히 패혈성 쇼크 상태로 진행하자 진단적 개복술을 통하여 응급 담낭절제술을 시행한 증례를 경험하였기에 문헌 고찰과 함께 보고한다.

참고문헌 (Reference)

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